January 18, 2018

Atlantic Radiology Imaging, P.C. v Travelers Prop. Cas. Co. of Am. (2018 NY Slip Op 50053(U))

Headnote

The provider's failure to fully respond to verification requests established that its no-fault claims were premature. The insurer obtained summary judgment dismissing the complaint, and the provider's cross motion was denied. The provider asserted that the follow-up request was issued two days beyond the 10-day period under 11 NYCRR 65-3.6. Even accepting that speculative assertion, the delay did not, under the circumstances, deprive the insurer of tolling of its 30-day period to pay or deny. The Appellate Term, First Department, affirmed the order.

Reported in New York Official Reports at Atlantic Radiology Imaging, P.C. v Travelers Prop. Cas. Co. of Am. (2018 NY Slip Op 50053(U))

[*1]
Atlantic Radiology Imaging, P.C. v Travelers Prop. Cas. Co. of Am.
2018 NY Slip Op 50053(U) [58 Misc 3d 148(A)]
Decided on January 18, 2018
Appellate Term, First 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This opinion is uncorrected and will not be published in the printed Official Reports.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 January 18, 2018
SUPREME COURT, APPELLATE TERM, FIRST DEPARTMENT
PRESENT: Shulman, P.J., Ling-Cohan, Gonzalez, JJ.
570322/17

Atlantic Radiology Imaging, P.C. a/a/o Nigel L. Russell, Plaintiff-Appellant,

against

Travelers Property Casualty Company of America, Defendant-Respondent.


Plaintiff appeals from an order of the Civil Court of the City of New York, New York County (Alexander M. Tisch, J.), entered February 1, 2016, which granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.

Per Curiam.

Order (Alexander M. Tisch, J.), entered February 1, 2016, affirmed, with $10 costs.

It being undisputed on this record that plaintiff failed to fully respond to the defendant-insurer’s verification requests, defendant established its prima facie entitlement to summary judgment dismissing the underlying first-party no-fault claims as premature (see St. Vincent Med. Care, P.C. v. Country Wide Ins. Co., 80 AD3d 599, 600 [2011]). Even accepting plaintiff’s speculative assertion that defendant’s followup verification request was issued two days beyond the 10-day period prescribed by the regulation (see 11 NYCRR 65-3.6), this does not, under the circumstances here presented, deprive defendant of the benefit of the tolling of the 30-day period during which an insurer must pay or deny the claim (see Infinity Health Prods., Ltd. v Eveready Ins. Co., 67 AD3d 862 [2009]; Triangle R Inc. v Praetorian Ins. Co., 30 Misc 3d 129[A], 2010 NY Slip Op 52294[U] [App Term, 1st Dept 2010]).

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.


I concurI concurI concur
Decision Date: January 18, 2018

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