August 31, 2012
Compas Med., P.C. v Delos Ins. Co. (2012 NY Slip Op 51715(U))
https://www.beynensonlaw.com/case-law/compas-med-p-c-v-delos-ins-co-2012-ny-slip-op-51715u/
- Decided
- August 31, 2012
- Citation
- 2012 NY Slip Op 51715(U) · 36 Misc 3d 153(A)
- Posture
- Summary judgment
- Outcome
- Provider prevailed
- Issues
- Verification requests
- Legal questions
- Outstanding verification and premature actions (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 Compas Med., P.C. v Delos Ins. Co. (2012 NY Slip Op 51715(U))
| Compas Med., P.C. v Delos Ins. Co. |
| 2012 NY Slip Op 51715(U) [36 Misc 3d 153(A)] |
| Decided on August 31, 2012 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., RIOS and ALIOTTA, JJ
2011-373 K C.
against
Delos Insurance Company, Appellant.
Appeal from an order of the Civil Court of the City of New York, Kings County (Carolyn E. Wade, J.), entered November 23, 2010. The order, insofar as appealed from, denied defendant’s cross motion for summary judgment dismissing the complaint.
ORDERED that the order, insofar as appealed from, is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, the Civil Court properly denied defendant’s cross motion for summary judgment dismissing the complaint, as there is a triable issue of fact as to whether verification is outstanding. Accordingly, the order, insofar as appealed from, is affirmed.
Pesce, P.J., Rios and Aliotta, JJ., concur.
Decision Date: August 31, 2012
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 unanswered verification requests make the provider’s claim premature, or justify denying it for nonresponse?
This decision: Fact issues remain on whether the verification defense applies
Held the insurer not entitled to summary judgment dismissing the complaint because a triable issue of fact existed as to whether verification remained outstanding.
Of the 385 decisions on this question in the Second Department courts and the Court of Appeals, 114 (this one included) are in the same category.
Similar decisions
- Compas Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51417(U))The insurer established proper mailing of verification requests and denials and timely denial after receipt of verification.
- Compas Med., P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51240(U))Conflicting proof of claim receipt and verification responses precluded summary judgment for either party.
- Compas Med., P.C. v Fiduciary Ins. Co. of Am. (2015 NY Slip Op 51472(U))The provider's summary judgment motion was denied because it failed to establish prima facie entitlement on its no-fault claim.
- Compas Med., P.C. v Travelers Ins. Co. (2016 NY Slip Op 51442(U))The insurer was granted summary judgment dismissing the sixth through eighth causes of action for failure to provide requested verification.
- Compas Med., P.C. v Allstate Ins. Co. (2016 NY Slip Op 51356(U))The insurer failed to establish timely mailing of the denials supporting its EUO nonappearance defense.