September 22, 2017
TAM Med. Supply Corp. v 21st Century Ins. Co. (2017 NY Slip Op 51238(U))
https://www.beynensonlaw.com/case-law/tam-med-supply-corp-v-21st-century-ins-co-2017-ny-slip-op51238u/
- Decided
- September 22, 2017
- Citation
- 2017 NY Slip Op 51238(U) · 57 Misc 3d 133(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Legal questions
- Proof of mailing (see the maps)
Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.
Summary
Editorial summary by Beynenson Law, not part of the court’s decision.
Reported in New York Official Reports at TAM Med. Supply Corp. v 21st Century Ins. Co. (2017 NY Slip Op 51238(U))
| TAM Med. Supply Corp. v 21st Century Ins. Co. |
| 2017 NY Slip Op 51238(U) [57 Misc 3d 133(A)] |
| Decided on September 22, 2017 |
| Appellate Term, Second 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| This opinion is uncorrected and will not be published in the printed Official Reports.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 September 22, 2017
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, MARTIN M. SOLOMON, JJ
2014-1585 Q C
against
21st Century Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell, Esq.), for appellant. Law Offices of Bryan M. Rothenberg (Sharon A. Brennan, Esq.), for respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Richard G. Latin, J.), entered June 9, 2014. The order, insofar as appealed from, granted the branch of defendant’s motion seeking summary judgment dismissing the second cause of action and, upon denying the branch of defendant’s motion seeking summary judgment dismissing the first cause of action, found, in effect pursuant to CPLR 3212 (g), that defendant had established proper mailing of the denial of the claim underlying that cause of action.
ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground of lack of medical necessity. Plaintiff appeals from so much of an order of the Civil Court as granted the branch of defendant’s motion seeking summary judgment dismissing the second cause of action and, upon denying the branch of defendant’s motion seeking summary judgment dismissing the first cause of action, found, in effect pursuant to CPLR 3212 (g), that defendant had established proper mailing of the denial of claim form underlying that cause of action.
Contrary to plaintiff’s sole argument on appeal, the proof submitted by defendant in support of its motion was sufficient to establish that the denial of claim forms at issue had been properly mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]).
Accordingly, the order, insofar as appealed from, is affirmed.
PESCE, P.J., ALIOTTA and SOLOMON, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: September 22, 2017
Legal questions
A question of no-fault law this decision rules on, from our Legal Questions pages. Bars count the decisions on the question by year and court, coloured by category; circles are this decision and the decisions on the question it cites or that cite it. Point at a bar or circle for details. The categories and summaries are Beynenson Law’s classification, made by a language model and checked by a second reading.
Did a party’s evidence establish that it mailed a no-fault claim, denial, verification request or examination notice?
This decision: The insurer's (or its agent's) proof established mailing of its denial, verification request or IME/EUO notice
Held the insurer's proof sufficient to establish that the denials had been properly mailed, rejecting the provider's sole argument on appeal.
Of the 1,400 decisions on this question in the Second Department courts and the Court of Appeals, 809 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co. (2008 NY Slip Op 04072) FollowedThe insurer raised factual issues concerning a proper timely denial and its entitlement to deny the hospital's claim.
Similar decisions
- TAM Med. Supply Corp. v American Tr. Ins. Co. (2016 NY Slip Op 51318(U))The insurer established an IME nonappearance defense on the first claim but failed to prove a timely denial of the second.
- TAM Med. Supply Corp. v National Liab. & Fire Ins. Co. (2016 NY Slip Op 51423(U))The insurer failed to establish proper mailing of IME scheduling letters, and the provider failed to establish prima facie entitlement to judgment.
- Tam Med. Supply Corp. v Fiduciary Ins. Co. of Am. (2016 NY Slip Op 51352(U))The insurer established that it first learned of the accident through an NF-2 form submitted more than 30 days after the accident.
- TAM Med. Supply Corp. v New York Cent. Mut. Fire Ins. Co. (2017 NY Slip Op 51248(U))The provider's affidavit created a presumption of verification receipt and raised a triable issue concerning prematurity.
- TAM Med. Supply Corp. v Tri State Consumers Ins. Co. (2017 NY Slip Op 51247(U))The provider's affidavit raised a triable issue as to whether it supplied verification sought under the 120-day rule.