July 28, 2008

Bronx Expert Radiology, P.C. v Motor Veh. Acc. Indem. Corp. (2008 NY Slip Op 51612(U))

Headnote

The provider failed to justify its three-month delay in submitting claims to MVAIC after learning that the vehicle's insurance had been canceled. MVAIC established that the claims were submitted late, denied them on that ground, and afforded an opportunity for reasonable justification under 11 NYCRR 65-3.3 (e). Even assuming inadvertent submission to another insurer justified the initial delay under 11 NYCRR 65-3.5 (l), the provider offered no reasonable justification for the subsequent three-month interval under 11 NYCRR 65-1.1. The Appellate Term, First Department, reversed the order and granted MVAIC's motion for summary judgment dismissing the complaint.

Reported in New York Official Reports at Bronx Expert Radiology, P.C. v Motor Veh. Acc. Indem. Corp. (2008 NY Slip Op 51612(U))

[*1]
Bronx Expert Radiology, P.C. v Motor Veh. Acc. Indem. Corp.
2008 NY Slip Op 51612(U) [20 Misc 3d 140(A)]
Decided on July 28, 2008
Appellate Term, First Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
This opinion is uncorrected and will not be published in the printed Official Reports.


Decided on July 28, 2008
APPELLATE TERM OF THE SUPREME COURT, FIRST DEPARTMENT

PRESENT: McKEON, P.J., SCHOENFELD, HEITLER JJ
570490/07.

Bronx Expert Radiology, P.C. a/a/o Jose Del Rosario, Plaintiff-Respondent, – –

against

Motor Vehicle Accident Indemnification Corporation, Defendant-Appellant.


Defendant appeals from an order of the Civil Court of the City of New York, Bronx County (Lizbeth Gonzalez, J.), dated January 23, 2007, which denied its motion for summary judgment dismissing the complaint.


Per Curiam.

Order (Lizbeth Gonzalez, J.), dated January 23, 2007, reversed, with $10 costs, and defendant’s motion for summary judgment dismissing the complaint granted. The Clerk is directed to enter judgment accordingly.

In this action to recover no fault benefits, defendant Motor Vehicle Accident Indemnification Corporation (MVAIC) established its prima facie entitlement to summary judgment by submitting evidence that health care services were rendered to plaintiff’s assignor on November 23, 2005, that plaintiff submitted its proof of claims to MVAIC on April 26, 2006, and that MVAIC denied the claims based on plaintiff’s untimely submissions of proof of claims and afforded plaintiff the opportunity to provide “reasonable justification” for its delay (see 11 NYCRR 65-3.3 [e]).

In opposition, plaintiff failed to raise a triable issue. Even assuming that plaintiff’s submission of the claims to New York Central Mutual Fire Insurance Company, on or about December 22, 2005, was inadvertent and justified plaintiff’s initial delay in submitting the claim to MVAIC (see 11 NYCRR 65-3.5[l]), plaintiff failed to provide a “reasonable justification” for the three-month delay between January 16, 2006, when it was apprised of New York Central’s denial of no-fault benefits based on the cancellation of the insurance policy prior to the date of the accident, and April 26, 2006, when it submitted its claims to MVAIC (see (see 11 NYCRR 65-1.1; N.Y. Arthroscopy & Sports Medicine PLLC v Motor Veh. Acc. Indem. Corp., 15 Misc 3d 89 [2007]).

We have considered plaintiff’s remaining arguments and find them unavailing.
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concurI concurI concur [*2]
Decision Date: July 28, 2008

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