May 18, 2015
Peace of Mind Social Work, P.C. v Travelers Ins. Co. (2015 NY Slip Op 50777(U))
https://www.beynensonlaw.com/case-law/peace-of-mind-social-work-p-c-v-travelers-ins-co-2015-ny-slip-op50777u/
- Decided
- May 18, 2015
- Citation
- 2015 NY Slip Op 50777(U) · 47 Misc 3d 149(A)
- Posture
- Trial
- Outcome
- Provider prevailed
- Legal questions
- Claimant's prima facie case at trial (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 Peace of Mind Social Work, P.C. v Travelers Ins. Co. (2015 NY Slip Op 50777(U))
| Peace of Mind Social Work, P.C. v Travelers Ins. Co. |
| 2015 NY Slip Op 50777(U) [47 Misc 3d 149(A)] |
| Decided on May 18, 2015 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports.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 May 18, 2015
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-2661 K C
against
Travelers Ins. Co., Appellant.
Appeal from a judgment of the Civil Court of the City of New York, Kings County (Ingrid Joseph, J.), entered August 3, 2011. The judgment, after a nonjury trial, awarded plaintiff the principal sum of $5,483.27.
ORDERED that the judgment is affirmed, with $25 costs.
At a nonjury trial in this action by a provider to recover assigned first-party no-fault benefits, the sole witness was plaintiff’s third-party biller. Although defendant’s counsel argued that plaintiff had failed to establish its prima facie case—since the witness was incapable of establishing a business record foundation, pursuant to CPLR 4518, for plaintiff’s claim forms, which had been admitted into evidence—the Civil Court entered judgment in favor of plaintiff.
Pursuant to the holding in Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co. (114 AD3d 33 [2013]), the testimony of plaintiff’s witness was sufficient to establish plaintiff’s prima facie case. As defendant failed to proffer a defense, the judgment is affirmed (see id.; Peace of Mind, Social Work, P.C. v Travelers Aetna Prop. Cas. Corp., 43 Misc 3d 127[A], 2014 NY Slip Op 50475[U] [App Term, 2d, 11th & 13th Jud Dists 2014]).
Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: May 18, 2015
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.
What must a no-fault claimant prove at trial to make out its prima facie case for overdue benefits?
This decision: Claimant's trial proof held to make out its prima facie case
Held the third-party biller's trial testimony established the provider's prima facie case, rejecting the insurer's argument that a CPLR 4518 business-record foundation for the claim forms was required.
Of the 103 decisions on this question in the Second Department courts and the Court of Appeals, 40 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co. (2013 NY Slip Op 08430) FollowedA provider need not prove a claim's merits for summary judgment where the insurer failed to timely and properly deny the claim.
- Peace of Mind, Social Work, P.C. v Travelers Aetna Prop. Cas. Corp. (2014 NY Slip Op 50475(U))The provider's third-party biller's testimony was sufficient to establish its prima facie case at a nonjury trial.
Similar decisions
- Peace of Mind, Social Work, P.C. v Travelers Prop. Cas. (2013 NY Slip Op 51119(U))The provider failed to establish its claim form's admissibility because its third-party witness did not lay a foundation for the source records.
- Empire State Psychological Servs., P.C. v Travelers Ins. Co. (2006 NY Slip Op 51869(U))The provider failed to prove its prima facie case at trial by offering only the insurer's interrogatory response acknowledging bills.
- V.S. Med. Servs., P.C. v Travelers Ins. Co. (2013 NY Slip Op 50973(U))The provider failed to identify the claims sued upon or prove they remained unpaid, so it did not establish a prima facie case at trial.
- Peace of Mind, Social Work, P.C. v MVAIC (2011 NY Slip Op 51834(U))The provider failed to establish its prima facie case at trial because it offered no proof of submitting a notice of intention to claim to MVAIC. Its billing witness testified only to creation and mailing of the claim form and nonpayment.
- Psychmetrics Med., P.C. v Travelers Ins. Co. (2008 NY Slip Op 52466(U))The provider failed to establish its prima facie case at trial because it called no witness to authenticate its claim form as a business record.