September 27, 2024
Bronx Community Med., P.C. v MVAIC (2024 NY Slip Op 51538(U))
https://www.beynensonlaw.com/case-law/bronx-community-med-p-c-v-mvaic-2024-ny-slip-op-51538u/
- Court
- Appellate Term, Second Department
- Decided
- September 27, 2024
- Citation
- 2024 NY Slip Op 51538(U) · 84 Misc 3d 129(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Legal questions
- 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 Bronx Community Med., P.C. v MVAIC (2024 NY Slip Op 51538(U))
[*1]| Bronx Community Med., P.C. v MVAIC |
| 2024 NY Slip Op 51538(U) [84 Misc 3d 129(A)] |
| Decided on September 27, 2024 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports.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 September 27, 2024
PRESENT: : CHEREÉ A. BUGGS, J.P., WAVNY TOUSSAINT, MARINA CORA MUNDY, JJ
2023-925 K C
against
MVAIC, Appellant.
Marshall & Marshall, PLLC (Angelique Evangelista and Frank D’Esposito of counsel), for appellant. The Rybak Firm, PLLC (Damin Toell and Richard Rozhik of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Jill R. Epstein, J.), dated August 10, 2023. The order, insofar as appealed from, denied defendant’s motion for summary judgment dismissing the complaint.
ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s motion for summary judgment dismissing the complaint is granted without prejudice.
In this action by a provider to recover assigned first-party no-fault benefits, defendant Motor Vehicle Accident Indemnification Corporation (sued herein as MVAIC) appeals from so much of an order of the Civil Court as denied MVAIC’s motion which sought summary judgment dismissing the complaint either on the ground that MVAIC had never received the claims at issue or that the action had been commenced after the three-year statute of limitations had expired. The order also denied plaintiff’s cross-motion for summary judgment.
MVAIC made a prima facie showing that it had not received the claim forms at issue. The affidavit submitted by plaintiff’s owner in opposition to MVAIC’s motion was insufficient to give rise to a presumption that those claim forms had been timely mailed to, and received by, MVAIC (see Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679 [2001]), as plaintiff’s owner repeatedly stated that he personally mailed the claim forms “to [the] insurance carrier,” without setting forth the name of the recipient or the address to which they were mailed, and the copies of the claim forms annexed to plaintiff’s cross-motion were dated after the date on which the claim forms were purportedly mailed “to [the] insurance carrier.” Consequently, [*2]MVAIC’s time to pay or deny plaintiff’s claims never began to run and MVAIC is entitled to summary judgment dismissing the complaint without prejudice, as it is premature (see Insurance Law § 5106 [a]; 11 NYCRR 65-3.8 [c]; Wave Med. Servs., P.C. v Metlife Auto & Home, 69 Misc 3d 138[A], 2020 NY Slip Op 51321[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2020]; cf. Veraso Med. Supply Corp. v NY City Tr. Auth., 63 Misc 3d 152[A], 2019 NY Slip Op 50754[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]).
Accordingly, the order, insofar as appealed from, is reversed and defendant’s motion for summary judgment dismissing the complaint is granted without prejudice.
BUGGS, J.P., TOUSSAINT and MUNDY, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: September 27, 2024
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.
Did a party’s evidence establish that it mailed a no-fault claim, denial, verification request or examination notice?
This decision: The provider's or claimant's proof did not establish mailing of its claim form, NF-2 or verification response
Held the provider owner's affidavit insufficient to raise a presumption of mailing because it named neither the recipient nor the address, and the annexed claim forms postdated the alleged mailing date.
Of the 1,341 decisions on this question in the Second Department courts and the Court of Appeals, 51 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- Veraso Med. Supply Corp. v NY City Tr. Auth. (2019 NY Slip Op 50754(U)) Contrasted (cf., but see)The provider's owner's affidavit raised a triable issue as to timely submission of the claim despite the transit authority's denial of receipt.
Similar decisions
- JFL Med. Care, P.C. v MVAIC (2024 NY Slip Op 50202(U))MVAIC failed to establish coverage exhaustion because it omitted the dates claims were received and fully verified.
- Queens Diagnostic Radiology, P.C. v MVAIC (2025 NY Slip Op 51147(U))The provider failed to justify submitting its claims to MVAIC more than 45 days after the services were rendered.
- Bronx Chiropractic Rehabilitation, P.C. v MVAIC (2024 NY Slip Op 50799(U))MVAIC's time to deny or seek verification runs from claim receipt, regardless of whether it has determined covered-person status.
- Active Care Med. Supply Corp. v MVAIC (2021 NY Slip Op 50450(U))MVAIC was entitled to dismissal, but conflicting proof of claim receipt required a hearing to determine whether dismissal would be with prejudice.
- Stand-Up MRI of the Bronx, P.C. v MVAIC Ins. Co. (2022 NY Slip Op 50789(U))The provider failed to establish that it gave MVAIC reasonable justification for submitting its claims after the 45-day deadline.