Justia New York Court of Appeals Opinion Summaries

Plaintiff is a health insurance company that offers a choice of federal government-regulated alternatives to Medicare known as Medicare Advantage plans. These plans allow Medicare-eligible individuals to purchase health insurance from private insurance companies. Those companies are reimbursed by the government for health care services provided to the plans’ members. Before the Supreme Judicial Court was Plaintiff’s demand for indemnification to cover losses resulting from health care claims for unprovided services paid through Plaintiff’s computer system. At issue was the coverage available to Plaintiff pursuant to Rider #3 of a financial institution bond issued by Defendant. The bond insured Plaintiff against various losses, and the Rider amended the bond to provide indemnification specifically for computer systems fraud. When Plaintiff suffered more than $18 million in losses for payment for fraudulent claims for services never actually performed under its Medicare Advantage plans, Plaintiff sought payment from Defendant for its post-deductible losses. Defendant denied coverage, and Plaintiff sued. Supreme Court granted summary judgment for Defendant. The Court of Appeals affirmed, holding that the Rider applies to losses resulting directly from fraudulent access, not to losses from the content submitted by authorized users. View "Universal Am. Corp. v Nat’l Union Fire Ins. Co. of Pittsburgh, PA" on Justia Law

Jesse Stipley (the decedent), a seventeen-year-old high school student, was killed in an automobile accident. During an authorized autopsy, the medical examiner removed, among other organs, the decedent’s brain, fixed it in formalin, and placed it in the autopsy room for further examination by a neuropathologist. The decedent’s body was subsequently retrieved from the mortuary, and a funeral was held. Approximately three months later, the decedent’s family discovered that the decedent’s brain had been retained by the medical examiner. Plaintiffs, the decedent’s family, commenced this action against the City of New York alleging negligent infliction of emotional distress resulting from the mishandling and withholding of their son’s brain. Supreme Court granted Plaintiffs’ motion for a directed verdict as to liability. After a trial, Plaintiffs were awarded $1 million in damages. That amount was subsequently reduced. The Court of Appeals reversed, holding that a medical examiner is not legally required to notify next of kin that organs, tissues or other specimens have been removed from the body during a lawful autopsy and retained by the medical examiner after such an autopsy. View "Shipley v. City of New York" on Justia Law

Eastchester Rehabilitation & Health Care Center cared for Edna Shannon for four years. During the fourth year, Family Service Society of Yonkers (FSS Yonkers) was appointed as guardian of Shannon’s person and property. Eastchester later made a claim with FSS Yonkers seeking compensation for services it rendered to Shannon that were not covered by Medicaid. Thereafter, Westchester County Department of Social Services (DSS) advised FSS Yonkers that Shannon was indebted to DSS for medical assistance paid on her behalf. After Shannon died, FSS Yonkers commenced this proceeding to settle its final account and seeking a determination as to how it should disburse Shannon’s remaining property. Supreme Court held that the balance of Shannon’s remaining property should be paid to DSS. The Appellate Division reversed. The Supreme Court reversed, holding (1) N.Y. Ment. Hyg. Law 81.44 does not permit a guardian to retain property of an incapacitated person after the incapacitated person has died for the purpose of paying a claim against the incapacitated person that arose before that person’s death; and (2) inasmuch as Eastchester’s claim for medical services rendered to Shannon was unrelated to the administration of her guardianship, section 81.44 does not allow FSS Yonkers to withhold from Shannon’s estate funds to pay Shannon’s debt to Eastchester. View "In re Shannon" on Justia Law

In 2004, Respondent pleaded guilty to sexual abuse in the first degree. Respondent was previously convicted in three separate cases to sexual abuse in the first degree, rape in the first degree, and sodomy in the second degree. As Respondent’s release date approached, the Attorney General commenced this N.Y. Mental Hyg. Law 10 proceeding seeking a determination that Respondent was a detained sex offender requiring civil management. After a dispositional hearing, Supreme Court issued an order finding that Respondent was a dangerous sex offender and ordering his confinement. Defendant appealed, arguing that Supreme Court improperly permitted an expert witness to testify via electronic video conferencing. The Appellate Division affirmed. The Court of Appeals affirmed, holding (1) Supreme Court erred by permitting the expert witness to testify via electronic appearance on rebuttal without a showing of exceptional circumstances; but (2) the error was harmless in light of the overwhelming evidence presented by the State. View "State v. Robert F." on Justia Law

Petitioner was convicted of murder and eventually released on lifetime parole supervision. Petitioner was subsequently charged with misdemeanor assault. Petitioner was found to be unfit to stand trial and was committed to the custody of the Office of Mental Health. While committed, Petitioner was charged with assault and harassment stemming from his attack on a fellow patient. The charges were eventually dismissed. Meanwhile, the New York State Department of Corrections and Community Supervision commenced parole revocation proceedings against Petitioner on the incident based on the patient attack. An administrative law judge (ALJ) recommended parole revocation. The Division of Parole adopted the ALJ’s recommendation, and Petitioner was incarcerated. While incarcerated, Petitioner commenced this N.Y. C.P.L.R. 78 contending that due process prohibits the Division from proceeding with a revocation hearing against a person who has been deemed mentally unfit to proceed to trial. Supreme Court denied the petition, determining that an assertion of incompetency does not bar parole revocation proceedings. The Appellate Division reversed. The Court of Appeals affirmed, holding that when a parolee lacks mental competency to stand trial, it is a violation of his or her due process rights to conduct a parole revocation hearing. View "Lopez v. Evans" on Justia Law

Petitioner was adjudicated a dangerous sex offender in need of confinement to a secure treatment facility. Petitioner later exercised his annual right to petition for discharge under N.Y. Mental Hyg. Law 10 and commenced a proceeding in Oneida County seeking his discharge from confinement. Petitioner then moved to change venue for the annual review hearing to New York County, citing to N.Y. Ment. Hyg. Law 10.08(e). Supreme Court denied the motion, finding that, while N.Y. Mental Hyg. Law 10.08(e) does allow venue to be changed for annual review hearings, Petitioner failed to establish the requisite good cause in this case. Thereafter, Supreme Court found that Petitioner remained a dangerous sex offender in need of confinement to a secure treatment facility. The Appellate Division affirmed. The Court of Appeals affirmed, holding (1) N.Y. Ment. Hyg. Law 10 authorizes a change of venue in article 10 annual hearings upon an appropriate showing of good cause; but (2) Petitioner failed to establish good cause for the change of venue. View "Tyrone D. v. State" on Justia Law

Respondent pleaded guilty to sex offenses, including sexual abuse in the first decree. When Respondent’s term of imprisonment neared its end, the State commenced a civil commitment proceeding against him pursuant to N.Y. Mental Hyg. Law 10. After a bench trial, Supreme Court imposed strict and intensive supervision (SIST) rather than confinement. Respondent was required to attend a sex offender treatment program, but due to his failure to cooperate, Respondent was discharged and later arrested. Supreme Court subsequently revoked Respondent’s release on SIST and committed him to a secure treatment facility, determining that the State had proven that Respondent was a dangerous sex offender requiring confinement. The Appellate Division affirmed on the merits. The Court of Appeals reversed, holding (1) the Mental Hygiene Law envisages a distinction between sex offenders who have difficulty controlling their sexual conduct and those who are unable to control it; and (2) the evidence was insufficient to support the trial court’s finding that Respondent had such an inability to control his behavior that he was likely to be a danger to others and to commit sex offenses if not confined to a secure treatment facility. View "State v. Michael M." on Justia Law

In these two matters, the State commenced civil commitment proceedings against Kenneth T. and Donald DD under N.Y. Mental Hyg. Law 10. After trials were held in both cases, it was found that the men had a condition, disease or disorder that prdisposed them to the commission of conduct constituting a sex offense and resulted in their having serious difficulty in controlling such conduct. Following dispositional hearings, both men were ordered to be confined. The Court of Appeals reversed in both cases, holding (1) the evidence was legally insufficient to support the conclusion that Kenneth T.’s mental conditions resulted in his having serious difficulty in controlling conduct constituting a sex offense; and (2) in Donald DD’s case, Supreme Court erred in using a diagnosis of antisocial personality disorder, together with testimony concerning Donald DD’s sex crimes, but without evidence of some independent mental abnormality diagnosis, to ground a finding of mental abnormality within the meaning of article 10. View "Matter of State of New York v. Donald DD" on Justia Law

Petitioners were found not responsible for crimes they committed by reason of mental disease or defect. Petitioners were eventually released from confinement into the community, subject to a five-year order of conditions. The New York State Office of Mental Health (OMH) later requested that the supervising court extend the order of conditions. In its proposed order, OMH asked the court to include an effective-evaluation provision, which would allow the OMH to seek judicial approval of a mandatory psychiatric evaluation in a secure facility if Petitioners failed to comply with the conditions of their release and refused to undergo voluntary examination. Petitioners sought writs of prohibition barred enforcement of the effective-evaluation provisions, arguing that the provisions were inconsistent with N.Y. Crim. Proc. Law 330.20(14)’s specific procedure for recommitment orders. The Appellate division granted the petitions, concluding that the effective-evaluation provision was barred by the recommitment provisions in section 330.20(14). The Court of Appeals reversed, holding that section 330.20(14) does not prohibit inclusion of an effective-evaluation provision in an order of conditions. View "Allen B. v. Sproat" on Justia Law

In 1968, Respondent pleaded guilty to rape and robbery. A federal court later vacated Respondent’s convictions. In 1978, Respondent was convicted of rape in the first degree. After Respondent was released on parole, he pleaded guilty in 1996 to rape in the first degree. Prior to Respondent’s release from custody, the State filed a petition under N.Y. Mental Hyg. Law 10 seeking a determination that Respondent was a detained sex offender requiring civil management. Respondent moved to preclude expert testimony relating to both the 1968 charges and an uncharged rape Respondent allegedly committed in 1978. Supreme Court denied the motion. After a trial, the jury returned a verdict finding that Respondent suffered from a mental abnormality qualifying him for civil management under article 10. Supreme Court subsequently ordered Respondent committed to a secure treatment facility. The Court of Appeals affirmed, holding (1) basis hearsay related to Respondent’s 1968 indictments for rape and robbery met minimum due process requirements and was properly admitted at trial; and (2) basis hearsay about Respondent’s uncharged rape was unreliable and should have been excluded, but its admission was harmless error. View "State v. John S." on Justia Law