October 11, 2016

Renelique v American Tr. Ins. Co. (2016 NY Slip Op 51495(U))

https://www.beynensonlaw.com/case-law/renelique-v-american-tr-ins-co-2016-ny-slip-op-51495u/

Court: Appellate Term, Second Department
Decided: October 11, 2016
Citation: 2016 NY Slip Op 51495(U) · 53 Misc 3d 138(A)
Posture: Summary judgment
Outcome: Split result
Issues: Verification requests
Legal questions: Outstanding verification and premature actions (see the maps)

Cite as

Renelique v American Tr. Ins. Co., 53 Misc 3d 138(A), 2016 NY Slip Op 51495(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016)

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 insurer's cross motion for summary judgment based on outstanding verification was denied on appeal. The Appellate Term, Second Department, modified the order and left the denial of the provider's motion intact. It relied on the companion appeal Performance Plus Med., P.C. v Nationwide Ins., No. 2013-2766 Q C, decided the same day, addressing dismissal of the action as premature.

Reported in New York Official Reports at Renelique v American Tr. Ins. Co. (2016 NY Slip Op 51495(U))

[*1]

Renelique v American Tr. Ins. Co.

2016 NY Slip Op 51495(U) [53 Misc 3d 138(A)]

Decided on October 11, 2016

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This opinion is uncorrected and will not be published in the printed Official Reports.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 October 11, 2016

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-2544 Q C

Pierre Jean Jacques Renelique, as Assignee of Stephanie Rouse, Appellant,
against
American Transit Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Cheree A. Buggs, J.), entered November 1, 2013. The order denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied; as so modified, the order is affirmed, without costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which denied plaintiff’s motion for summary judgment, and granted defendant’s cross motion for summary judgment dismissing the complaint on the ground that the action was premature because plaintiff had failed to provide requested verification.

For the reasons stated in Performance Plus Med., P.C., as Assignee of Melanna Luckie v Nationwide Ins. (____ Misc 3d ____, 2016 NY Slip Op ______ [appeal No. 2013-2766 Q C], decided herewith), the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied.

Pesce, P.J., Aliotta and Solomon, JJ., concur.

Decision Date: October 11, 2016

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: Fact issues remain on whether the verification defense applies

Held the insurer was not entitled to summary judgment dismissing the complaint as premature for failure to provide requested verification, for reasons incorporated from a companion decision.

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, 114 (this one included) are in the same category.

Similar decisions

Renelique v Tri State Consumers Ins. Co. (2016 NY Slip Op 51536(U))The insurer's summary judgment motion based on outstanding verification was denied on appeal.
Renelique v Allstate Ins. Co. (2016 NY Slip Op 51357(U))The insurer's affidavits failed to establish an office mailing procedure ensuring timely mailing of its denial of claim.
Renelique v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 50868(U))The insurer's affidavit established timely and proper mailing of the denial based on the assignor's IME nonappearance.
Renelique v Travelers Ins. Co. (2016 NY Slip Op 50911(U))The provider's affidavit raised a factual issue as to whether the insurer received requested verification and the action was premature.
Renelique v National Liab. & Fire Ins. Co. (2016 NY Slip Op 51615(U))The insurer failed to establish that the assignor's misrepresentation of residence in procuring the policy was material as a matter of law.