July 21, 2017

Harbor Chiropractic, P.C. v Travelers Ins. Co. (2017 NY Slip Op 50959(U))

https://www.beynensonlaw.com/case-law/harbor-chiropractic-p-c-v-travelers-ins-co-2017-ny-slip-op-50959u/

Court: Appellate Term, Second Department
Decided: July 21, 2017
Citation: 2017 NY Slip Op 50959(U) · 56 Misc 3d 135(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Verification requests
Legal questions: Outstanding verification and premature actions (see the maps)

Cite as

Harbor Chiropractic, P.C. v Travelers Ins. Co., 56 Misc 3d 135(A), 2017 NY Slip Op 50959(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017)

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.

The provider failed to show that requested verification was supplied before suit, leaving its action premature. The insurer established nonreceipt in support of its summary judgment motion. The Civil Court, Queens County, denied the motion but limited trial issues under CPLR 3212 (g) to whether the provider properly responded to the verification requests. The provider did not challenge the finding that the insurer was otherwise entitled to judgment, and its opposition did not establish a pre-suit response. The Appellate Term, Second Department, reversed the order, insofar as appealed from, and granted the insurer summary judgment dismissing the complaint as premature.

Reported in New York Official Reports at Harbor Chiropractic, P.C. v Travelers Ins. Co. (2017 NY Slip Op 50959(U))

[*1]

Harbor Chiropractic, P.C. v Travelers Ins. Co.

2017 NY Slip Op 50959(U) [56 Misc 3d 135(A)]

Decided on July 21, 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This opinion is uncorrected and will not be published in the printed Official Reports.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 July 21, 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
2014-1809 Q C

Harbor Chiropractic, P.C., as Assignee of Iwona Wakuluk, Respondent,
against
Travelers Insurance Company, Appellant.

Law Offices of Aloy O. Ibuzor (Miriam Granov, Esq.), for appellant. The Odierno Law Firm, P.C. (Paul A. Bargellini, Esq.), for respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Jodi Orlow, J.), entered June 26, 2014. The order, insofar as appealed from and as limited by the brief, denied defendant’s motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s motion for summary judgment dismissing the complaint is granted.

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 that the action is premature due to plaintiff’s failure to provide requested verification. The Civil Court denied defendant’s motion but, in effect, limited the issues for trial, pursuant to CPLR 3212 (g), to whether plaintiff properly responded to defendant’s verification requests. As limited by its brief, defendant appeals from so much of the order as denied its motion.

Defendant’s moving papers demonstrated, prima facie, that it had not received the requested verification. In opposition to the motion, plaintiff did not show that the requested verification had been provided to defendant prior to the commencement of the action. In view of the foregoing, and as plaintiff has not challenged the Civil Court’s finding, in effect, that defendant is otherwise entitled to judgment, the order, insofar as appealed from, is reversed, and defendant’s motion for summary judgment dismissing the complaint on the ground that the action is premature is granted.

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

ENTER:
Paul Kenny
Chief Clerk
Decision Date: July 21, 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.

Outstanding verification and premature actions

Open the full map

Did unanswered verification requests make the provider’s claim premature, or justify denying it for nonresponse?

This decision: Timely requests went unanswered; the claim is not overdue and the action is premature

Held the action premature and granted the insurer summary judgment because it showed prima facie that it had not received the requested verification and the provider did not show it was provided before suit.

Premature: verification outstandingNonresponse denial upheldTriable issueInsurer's showing failsProvider compliedThis decision

Of the 385 decisions on this question in the Second Department courts and the Court of Appeals, 153 (this one included) are in the same category.

Similar decisions

Island Life Chiropractic, P.C. v Travelers Ins. Co. (2016 NY Slip Op 51413(U))The provider's mailing affidavit raised a factual issue whether the insurer received requested verification, precluding dismissal as premature.
New Horizon Surgical Ctr., L.L.C. v Travelers Ins. (2019 NY Slip Op 50281(U))The provider's action was premature because its verification submissions did not include the requested signed informed consent form.
Doctor Goldshteyn Chiropractic, P.C. v Travelers Indem. Co. (2017 NY Slip Op 51816(U))The provider's action was premature because the insurer had not received the requested verification.
T & S Med. Supply Corp. v Travelers Ins. Co. (2018 NY Slip Op 51597(U))The provider's owner's affidavit raised a factual issue about receipt of verification and whether the action was premature.
Lefferts Gardens Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co. (2022 NY Slip Op 50599(U))The provider's action was premature because it failed to respond to the insurer's timely and proper verification requests.