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SS Med. Care, P.C. v. Eveready Ins. Co.

Supreme Court, Appellate Term, Second Dept., 2, 11 and 13 Judicial Districts.
Aug 20, 2014
44 Misc. 3d 141 (N.Y. App. Term 2014)

Opinion

No. 2012–519KC.

2014-08-20

SS MEDICAL CARE, P.C. as Assignee of Charles Robinson, Respondent, v. EVEREADY INS. CO., Appellant.


Present: PESCE, P.J., ALIOTTA and SOLOMON, JJ.

Appeal from an order of the Civil Court of the City of New York, Kings County (Katherine A. Levine, J.), entered July 26, 2011. The order, insofar as appealed from, upon denying plaintiff's motion for summary judgment, made CPLR 3212(g) findings in plaintiff's favor, and denied defendant's cross motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, the CPLR 3212(g) findings in plaintiff's favor are vacated, and defendant's cross motion for summary judgment dismissing the complaint is granted.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for, among other things, summary judgment, and defendant cross-moved for summary judgment dismissing the complaint on the ground that the action is premature due to plaintiff's failure to provide requested verification. Insofar as is relevant to this appeal, the Civil Court, upon denying plaintiff's motion, made CPLR 3212(g) findings in plaintiff's favor, denied defendant's cross motion, and limited the issues for trial.

In support of its cross motion for summary judgment dismissing the complaint, defendant submitted an affidavit by its claims examiner which established that defendant had timely mailed its verification requests and follow-up verification requests ( see St. Vincent's Hosp. of Richmond v. Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Delta Diagnostic Radiology, P.C. v. Chubb Group of Ins., 17 Misc.3d 16 [App Term, 2d & 11th Jud Dists 2007] ). Defendant demonstrated that it had not received the requested verification. Plaintiff did not oppose defendant's cross motion. Contrary to the Civil Court's statement, there is nothing in the record which would require defendant to prove that the copies of the verification letters annexed to defendant's cross motion had not been tampered with or altered ( see Schozer v. William Penn Life Ins. Co. of NY, 84 N.Y.2d 639, 643 [1994]; People v. Dicks, 100 AD3d 528 [2012]; Rotanelli v. Longo, 210 A.D.2d 392 [1994] ). As the 30–day period within which defendant was required to pay or deny the claims did not begin to run ( see Insurance Department Regulations [11 NYCRR] § 65–3.8 [a]; Central Suffolk Hosp. v. New York Cent. Mut. Fire Ins. Co., 24 AD3d 492 [2005]; Hospital for Joint Diseases v. State Farm Mut. Auto. Ins. Co., 8 AD3d 533 [2004]; D & R Med. Supply v. American Tr. Ins. Co., 32 Misc.3d 144 [A], 2011 N.Y. Slip Op 51727[U] [App Term, 2d, 11th & 13th Jud Dists 2011] ), plaintiff's action is premature.

Accordingly, the order, insofar as appealed from, is reversed, the CPLR 3212(g) findings in plaintiff's favor are vacated, and defendant's cross motion for summary judgment dismissing the complaint is granted.

PESCE, P.J., ALIOTTA and SOLOMON, JJ., concur.


Summaries of

SS Med. Care, P.C. v. Eveready Ins. Co.

Supreme Court, Appellate Term, Second Dept., 2, 11 and 13 Judicial Districts.
Aug 20, 2014
44 Misc. 3d 141 (N.Y. App. Term 2014)
Case details for

SS Med. Care, P.C. v. Eveready Ins. Co.

Case Details

Full title:SS MEDICAL CARE, P.C. as Assignee of Charles Robinson, Respondent, v…

Court:Supreme Court, Appellate Term, Second Dept., 2, 11 and 13 Judicial Districts.

Date published: Aug 20, 2014

Citations

44 Misc. 3d 141 (N.Y. App. Term 2014)
2014 N.Y. Slip Op. 51305
998 N.Y.S.2d 308