December 17, 2014

City Chiropractic, P.C. v Eveready Ins. Co. (2014 NY Slip Op 51802(U))

Headnote

The court considered the case of City Chiropractic, P.C. as Assignee of Kamesha Campbell v. Eveready Ins. Co., which involved the plaintiff seeking to recover assigned first-party no-fault benefits. The main issue decided was whether the defendant had timely mailed its verification request and follow-up verification requests as required by law. The court held that the defendant had demonstrated that it had not received all of the verification requested, and the plaintiff did not provide evidence that such verification had been provided to the defendant prior to the commencement of the action. Therefore, the 30-day period within which the defendant was required to pay or deny the claims at issue did not begin to run, and the plaintiff's action was deemed premature. As a result, the judgment was reversed, and the defendant's cross motion for summary judgment dismissing the complaint was granted.

Reported in New York Official Reports at City Chiropractic, P.C. v Eveready Ins. Co. (2014 NY Slip Op 51802(U))

City Chiropractic, P.C. v Eveready Ins. Co. (2014 NY Slip Op 51802(U)) [*1]
City Chiropractic, P.C. v Eveready Ins. Co.
2014 NY Slip Op 51802(U) [46 Misc 3d 128(A)]
Decided on December 17, 2014
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This opinion is uncorrected and will not be published in the printed Official Reports.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 December 17, 2014

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-920 K C
City Chiropractic, P.C. as Assignee of KAMESHA CAMPBELL, Respondent,

against

Eveready Ins. Co., Appellant.

Appeal from an order of the Civil Court of the City of New York, Kings County (Carol Ruth Feinman, J.), entered December 16, 2011, deemed from a judgment of the same court entered February 17, 2012 (see CPLR 5501 [c]). The judgment, entered pursuant to the December 16, 2011 order granting plaintiff’s motion for summary judgment and denying defendant’s cross motion for summary judgment dismissing the complaint, awarded plaintiff the principal sum of $3,087.90.

ORDERED that the judgment is reversed, with $30 costs, the order entered December 16, 2011 is vacated, plaintiff’s motion for summary judgment is denied and defendant’s cross motion for summary judgment dismissing the complaint is granted.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court which granted plaintiff’s motion for summary judgment and denied defendant’s cross motion for summary judgment dismissing the complaint. A judgment was subsequently entered, from which the appeal is deemed to have been taken (see CPLR 5501 [c]).

The affidavit of defendant’s no-fault claims examiner established that defendant had timely mailed its verification request and follow-up verification requests (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]). Defendant demonstrated that it had not received all of the verification requested, and, in opposition to defendant’s cross motion, plaintiff did not show that such verification had been provided to defendant prior to the commencement of this action. Consequently, the 30-day period within which defendant was required to pay or deny the claims at issue did not begin to run (see 11 NYCRR 65-3.8 [a]; Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492 [2005]; Hospital for Joint Diseases v State Farm Mut. Auto. Ins. Co., 8 AD3d 533 [2004]; D & R Med. Supply v American Tr. Ins. Co., 32 Misc 3d 144[A], 2011 NY Slip Op 51727[U] [App Term, 2d, 11th & 13th Jud Dists 2011]), and, thus, plaintiff’s action is premature.

Accordingly, the judgment is reversed, the order entered December 16, 2011 is vacated, plaintiff’s motion for summary judgment is denied and defendant’s cross motion for summary judgment dismissing the complaint is granted.

Pesce, P.J., Aliotta and Solomon, JJ., concur.


Decision Date: December 17, 2014