February 21, 2008

Matter of Travelers Indem. Co. of Conn. v Glenwood Med., P.C. (2008 NY Slip Op 01598)

Headnote

An insurer's reconsideration of a denied no-fault claim does not extend the claim's accrual date for statute-of-limitations purposes. The Appellate Division, First Department, reversed the order denying the insurer's petition and permanently stayed arbitration. The provider demanded arbitration more than six years after the insurer had denied the claim in full for lack of medical necessity. The six-year limitation in CPLR 213 (2), rather than CPLR 214 (2), applied. Reconsideration prompted by unsolicited medical information did not move accrual to the second denial; accrual remained the statutory payment due date under Insurance Law § 5106 (a) and 11 NYCRR 65-3.8.

Reported in New York Official Reports at Matter of Travelers Indem. Co. of Conn. v Glenwood Med., P.C. (2008 NY Slip Op 01598)

Matter of Travelers Indem. Co. of Conn. v Glenwood Med., P.C.
2008 NY Slip Op 01598 [48 AD3d 319]
February 21, 2008
Appellate Division, First Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, April 16, 2008


In the Matter of The Travelers Indemnity Company of Connecticut, Appellant,
v
Glenwood Medical, P.C., Respondent.

—[*1] Carol R. Finocchio, New York City, for appellant.

Fazio, Rynsky & Associates, LLP, Syosset (David N. Vozza of counsel), for respondent.

Order, Supreme Court, New York County (Alice Schlesinger, J.), entered on or about June 13, 2003, which denied petitioner insurer’s application to permanently stay arbitration of respondent medical provider’s claim for payment of no-fault first-party benefits for services provided to petitioner’s insured, unanimously reversed, on the law, with costs, the petition granted, and the arbitration permanently stayed.

The claim, which is subject to the six-year statute of limitations in CPLR 213 (2), not the three-year statute in CPLR 214 (2) (Benson v Boston Old Colony Ins. Co., 134 AD2d 214, 215 [1st Dept 1987], lv denied 71 NY2d 801 [1988]; Mandarino v Travelers Prop. Cas. Ins. Co., 37 AD3d 775 [2d Dept 2007]), was not timely interposed where it had been denied in full by the insurer, for lack of medical necessity, more than six years before the provider demanded arbitration (see Benson). Contrary to the motion court, the insurer’s subsequent reconsideration of the same claim based on the provider’s unsolicited submission of additional medical information did not extend the accrual date of the claim, i.e., the due date for payment as fixed by statute (Insurance Law § 5106 [a]; 11 NYCRR 65-3.8), until the insurer’s second denial of the claim less than six years before the provider’s demand for arbitration. Concur—Lippman, P.J., Andrias, Nardelli, Buckley and Acosta, JJ.

Cited in this decision

Cited by

Similar decisions