June 3, 2016
Renelique v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 50868(U))
https://www.beynensonlaw.com/case-law/renelique-v-new-york-cent-mut-fire-ins-co-2016-ny-slip-op50868u/
- Decided
- June 3, 2016
- Citation
- 2016 NY Slip Op 50868(U) · 51 Misc 3d 151(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Legal questions
- No-show: coverage defense or precludable? · 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 Renelique v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 50868(U))
| Renelique v New York Cent. Mut. Fire Ins. Co. |
| 2016 NY Slip Op 50868(U) [51 Misc 3d 151(A)] |
| Decided on June 3, 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| This opinion is uncorrected and will not be published in the printed Official Reports.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 June 3, 2016
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-1755 Q C
against
New York Central Mutual Fire Insurance Company, Respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Maureen A. Healy, J.), entered April 25, 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 affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment, and defendant cross-moved for summary judgment dismissing the complaint on the ground that it had timely and properly denied the claims based on plaintiff’s assignor’s failure to appear for independent medical examinations. The Civil Court denied plaintiff’s motion and granted defendant’s cross motion.
Contrary to plaintiff’s contention on appeal, the affidavit submitted by defendant in support of its motion established the timely and proper mailing of the denial of claim form (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]). As plaintiff’s remaining contentions are improperly raised for the first time on appeal and are speculative, the order is affirmed.
Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: June 03, 2016
Legal questions (2)
Questions 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.
Is an IME/EUO no-show defense precluded if the insurer did not timely deny the claim on that ground?
This decision: Timely denial required as part of the no-show defense, and the insurer showed it
Held the insurer's affidavit established timely and proper mailing of its denial based on the assignor's IME nonappearance, rejecting the provider's challenge, so dismissal on the no-show defense was affirmed.
Of the 508 decisions on this question in the Second Department courts and the Court of Appeals, 338 (this one included) are in the same category.
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 affidavit established timely and proper mailing of its IME no-show denial, rejecting the provider's preserved challenge 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
- Renelique v National Liab. & Fire Ins. Co. (2016 NY Slip Op 51613(U))The insurer failed to prove mailing of the IME scheduling letters and therefore failed to establish that the assignor's IMEs were properly scheduled.
- 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 American Tr. Ins. Co. (2016 NY Slip Op 51546(U))The insurer's motion for summary judgment dismissing the provider's claims as premature for outstanding verification was denied on appeal.
- 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.
- Pierre Jean Renelique, MD, P.C. v Farmington Cas. Co. (2016 NY Slip Op 51420(U))The insurer failed to establish proper mailing of the letters scheduling the assignor's IMEs through proof of office mailing practices.