October 27, 2017

Adelaida M. Laga, PT v Hereford Ins. Co. (2017 NY Slip Op 51462(U))

Headnote

The court considered the fact that the plaintiff, a provider, was seeking to recover assigned first-party no-fault benefits, and the defendant had moved for summary judgment dismissing the complaint on the basis that the action was premature due to the plaintiff's failure to provide requested verification. The main issue decided was whether the requested verification remained outstanding. The holding of the court was that while the defendant had made a prima facie showing that it did not receive the requested verification, the affidavit submitted by the plaintiff in opposition to the motion was sufficient to create a presumption that the verification had been mailed to and received by the defendant. Therefore, there was a triable issue of fact as to whether the requested verification remained outstanding, and the Civil Court properly denied the defendant's motion for summary judgment dismissing the complaint as premature. The order was affirmed.

Reported in New York Official Reports at Adelaida M. Laga, PT v Hereford Ins. Co. (2017 NY Slip Op 51462(U))

Adelaida M. Laga, PT v Hereford Ins. Co. (2017 NY Slip Op 51462(U)) [*1]
Adelaida M. Laga, PT v Hereford Ins. Co.
2017 NY Slip Op 51462(U) [57 Misc 3d 146(A)]
Decided on October 27, 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This opinion is uncorrected and will not be published in the printed Official Reports.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 October 27, 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
NO. 2014-2637 K C
Adelaida M. Laga, PT, as Assignee of Joseph, Presnel, Respondent,

against

Hereford Insurance Co., Appellant.

Law Offices of Lawrence R. Miles ( Lawrence R. Miles, Esq.), for appellant. The Rybak Firm, PLLC (Oleg Rybak, Esq.), for respondent (no brief filed).

Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered October 3, 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 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 that the action was premature because plaintiff had failed to provide requested verification. By order entered October 3, 2014, the Civil Court denied defendant’s motion, but held, in effect pursuant to CPLR 3212 (g), that the only issue for trial was whether the verification remained outstanding. As limited by its brief, defendant appeals from so much of the order as denied its motion.

While defendant made a prima facie showing that it had not received the requested verification, the affidavit submitted by plaintiff in opposition to defendant’s motion was sufficient to give rise to a presumption that the requested verification had been mailed to, and received by, defendant (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]). As a triable issue of fact exists as to whether the requested verification remained outstanding, the Civil Court properly denied defendant’s motion for summary judgment dismissing the complaint as premature (see Compas Med., P.C. v Praetorian Ins. Co., 49 Misc 3d 152[A], 2015 NY Slip Op 51776[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]).

Accordingly, the order, insofar as appealed from, is affirmed.

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


ENTER:
Paul Kenny
Chief Clerk
Decision Date: October 27, 2017