October 5, 2016

Compas Med., P.C. v Travelers Ins. Co. (2016 NY Slip Op 51442(U))

https://www.beynensonlaw.com/case-law/compas-med-p-c-v-travelers-ins-co-2016-ny-slip-op51442u/

Court: Appellate Term, Second Department
Decided: October 5, 2016
Citation: 2016 NY Slip Op 51442(U) · 53 Misc 3d 136(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Verification requests
Legal questions: Outstanding verification and premature actions (see the maps)

Cite as

Compas Med., P.C. v Travelers Ins. Co., 53 Misc 3d 136(A), 2016 NY Slip Op 51442(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016)

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.

The insurer was granted summary judgment dismissing the sixth through eighth causes of action for failure to provide requested verification. The Appellate Term, Second Department, affirmed the order, insofar as appealed from, for the reasons stated in the companion appeal decided the same day, No. 2014-766 Q C.

Reported in New York Official Reports at Compas Med., P.C. v Travelers Ins. Co. (2016 NY Slip Op 51442(U))

[*1]

Compas Med., P.C. v Travelers Ins. Co.

2016 NY Slip Op 51442(U) [53 Misc 3d 136(A)]

Decided on October 5, 2016

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This opinion is uncorrected and will not be published in the printed Official Reports.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 5, 2016

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2014-779 Q C

Compas Medical, P.C., as Assignee of KEVIN JACQUES, Appellant,
against
Travelers Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Ulysses Bernard Leverett, J.), entered March 18, 2014. The order, insofar as appealed from as limited by the brief, granted the branches of defendant’s motion seeking summary judgment dismissing the sixth through eighth causes of action.

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, plaintiff appeals, as limited by its brief, from so much an order of the Civil Court as granted the branches of defendant’s motion seeking summary judgment dismissing the sixth through eighth causes of action on the ground that plaintiff had failed to provide requested verification.

For the reasons stated in Compas Med., P.C., as Assignee of Kevin Jacques v Travelers Ins. Co. (— Misc 3d —, 2016 NY Slip Op — [appeal No. 2014-766 Q C], decided herewith), the order, insofar as appealed from, is affirmed.

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

Decision Date: October 05, 2016

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.

Outstanding verification and premature actions

Open the full map

Did unanswered verification requests make the provider’s claim premature, or justify denying it for nonresponse?

This decision: Timely requests went unanswered; the claim is not overdue and the action is premature

Affirmed dismissal of three causes of action because the provider had failed to provide the verification the insurer requested, for reasons incorporated from a companion decision.

Premature: verification outstandingNonresponse denial upheldTriable issueInsurer's showing failsProvider compliedThis decision

Of the 385 decisions on this question in the Second Department courts and the Court of Appeals, 153 (this one included) are in the same category.

Similar decisions

Compas Med., P.C. v Travelers Insurance Company (2016 NY Slip Op 51424(U))The insurer proved a verification defense to one claim but lacked personal-knowledge proof of EUO nonappearance for seven others.
Compas Med., P.C. v American Tr. Ins. Co. (2016 NY Slip Op 51545(U))The insurer's cross motion to dismiss the first through fifth causes of action on summary judgment for outstanding verification was denied on appeal.
Compas v Travelers Ins. Co. (2018 NY Slip Op 50821(U))The insurer established the provider's EUO nonappearances through an affirmation from the attorney present to conduct the EUOs. The provider challenged the sufficiency of the affirmation in its action for assigned no-fault benefits.
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 Delos Ins. Co. (2012 NY Slip Op 51715(U))The insurer's cross motion for summary judgment was denied because a triable issue remained as to whether verification was outstanding.