October 11, 2011
Complete Med. Servs. of NY, P.C. v MVAIC (2011 NY Slip Op 51835(U))
https://www.beynensonlaw.com/case-law/complete-med-servs-of-ny-p-c-v-mvaic-2011-ny-slip-op-51835u/
- Court
- Appellate Term, Second Department
- Decided
- October 11, 2011
- Citation
- 2011 NY Slip Op 51835(U) · 33 Misc 3d 127(A)
- Posture
- Summary judgment
- Outcome
- Provider prevailed
- Later treatment
- Followed in 3 later decisions (see Cited by)
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 Complete Med. Servs. of NY, P.C. v MVAIC (2011 NY Slip Op 51835(U))
[*1]| Complete Med. Servs. of NY, P.C. v MVAIC |
| 2011 NY Slip Op 51835(U) [33 Misc 3d 127(A)] |
| Decided on October 11, 2011 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
PRESENT: : PESCE, P.J., RIOS and STEINHARDT, JJ
2009-1570 Q C.
against
MVAIC, Appellant.
Appeals from an order of the Civil Court of the City of New York, Queens County (Diane A.
Lebedeff, J.), entered May 18, 2009 and from a judgment of the same court entered June 23,
2009. The order granted plaintiff’s motion for summary judgment. The judgment, entered upon
the order, awarded plaintiff the principal sum of $3,062.24.
ORDERED that the appeal from the order is dismissed; and it is further,
ORDERED that the judgment is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment. Defendant Motor Vehicle Accident Indemnification Corporation (sued herein as MVAIC) opposed plaintiff’s motion, arguing, among other things, that plaintiff was not entitled to recover no-fault benefits from MVAIC because plaintiff never established that its assignor was a resident of New York State and, thus, plaintiff had failed to establish its prima facie case. By order entered May 18, 2009, the Civil Court granted plaintiff’s motion. A judgment was entered in favor of plaintiff on June 23, 2009. MVAIC appeals from both the order and the judgment.
The appeal from the order is dismissed as the right of direct appeal therefrom terminated with the entry of judgment (see Matter of Aho, 39 NY2d 241 [1976]). The issues raised on the appeal from the order are brought up for review and have been considered on the appeal from the judgment (see CPLR 5501 [a] [1]).
Although MVAIC contends that plaintiff’s assignor failed to demonstrate that she was a resident of New York State (see Insurance Law § 5202 [b]), the record establishes that defendant [*2]received the notarized notice of intention to make claim form, executed by plaintiff’s assignor one day after the accident, which form sets forth the New York residence of plaintiff’s assignor (see generally Insurance Law § 5221 [b] [2]). In addition, plaintiff’s moving papers establish that plaintiff’s claim form for the services at issue was mailed to MVAIC (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]), that the claim was not paid, that MVAIC did not timely deny plaintiff’s claim and that the claim form was admissible pursuant to CPLR 4518 (see Art of Healing Medicine, P.C. v Travelers Home & Mar. Inc. Co., 55 AD3d 644 [2008]; Dan Med., P.C. v New York Cent. Mut. Fire Ins. Co., 14 Misc 3d 44 [App Term, 2d & 11th Jud Dists 2006]). In light of the foregoing, plaintiff made a prima facie showing of its entitlement to summary judgment (see New York & Presbyt. Hosp. v Allstate Ins. Co., 31 AD3d 512 [2006]; cf. Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]).
As MVAIC’s remaining contention lacks merit, the judgment is affirmed.
Pesce, P.J., Rios and Steinhardt, JJ., concur.
Decision Date: October 11, 2011
Legal questions (2)
Questions 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.
On summary judgment or another pretrial motion, what must a no-fault claimant show to establish its prima facie case?
This decision: Claimant's proof held to make out its prima facie case
Rejected the argument that the provider's prima facie case failed for lack of residency proof and held it established mailing, nonpayment, no timely denial and the claim form's CPLR 4518 admissibility.
Of the 990 decisions on this question in the Second Department courts and the Court of Appeals, 446 (this one included) are in the same category.
Against MVAIC, was the claimant shown to be a qualified, covered person meeting article 52’s conditions?
This decision: Court finds the claimant qualified/covered, or the condition met or excused, on the claimant's own proof
Held the assignor's residency shown because MVAIC received her notarized notice of intention to make claim, executed the day after the accident, which set forth her New York residence.
Of the 223 decisions on this question in the Second Department courts and the Court of Appeals, 5 (this one included) are in the same category. One decision in other departments that cites or is cited by this one is on the full map.
Cited in this decision
A label shows how this decision treated the case it cites.
- St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co. (2008 NY Slip Op 04072) FollowedThe insurer raised factual issues concerning a proper timely denial and its entitlement to deny the hospital's claim.
- Art of Healing Medicine, P.C. v Travelers Home & Mar. Ins. Co. (2008 NY Slip Op 07846) FollowedThe providers failed to establish a prima facie case because they did not demonstrate the admissibility of their billing records.
- Dan Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 26483) FollowedThe provider failed to establish its prima facie case because its corporate officer did not lay a business-records foundation for the claim documents.
- New York & Presbyt. Hosp. v Allstate Ins. Co. (2006 NY Slip Op 05602) FollowedThe insurer proved a timely denial but failed to establish that the provider's treatment was unrelated to the accident.
- Westchester Med. Ctr. v Nationwide Mut. Ins. Co. (2010 NY Slip Op 08933) Contrasted (cf., but see)The provider failed to establish entitlement to summary judgment because the insurer partially paid and denied the claim within 30 days.
Cited by
A label shows how the later decision treated this one.
- Allstate Social Work & Psychological Svcs, P.L.L.C. v MVAIC (2012 NY Slip Op 51498(U)) FollowedMVAIC failed to establish lack of New York residency where its own submissions included sworn documents stating the assignor's Brooklyn address.
- Bronx Chiropractic Rehabilitation, P.C. v MVAIC (2024 NY Slip Op 50799(U)) FollowedMVAIC's time to deny or seek verification runs from claim receipt, regardless of whether it has determined covered-person status.
- Premium Acupuncture, P.C. v MVAIC (2012 NY Slip Op 51534(U)) FollowedMVAIC bears the burden of establishing that a provider's assignors are not qualified persons based on lack of New York residency.
- Delta Diagnostic Radiology, P.C. v MVAIC (2014 NY Slip Op 51261(U))MVAIC's residency defense lacked merit because the notarized notice of intention to make claim and police report stated the assignor's New York residence.
- Central Radiology Servs., P.C. v MVAIC (2014 NY Slip Op 24402)MVAIC's lack-of-coverage defense based on an assignor's residency is not precluded by an untimely denial.
Similar decisions
- Village Med. Supply, Inc. v MVAIC (2016 NY Slip Op 51421(U))The provider failed at trial to establish the assignor's eligibility for MVAIC benefits through residency proof and a notice-of-intention affidavit.
- Ap Orthopedic & Rehabilitation, P.C. v Mvaic (2011 NY Slip Op 51448(U))The assignor's failure to provide proof of New York residency defeated the provider's claim for no-fault benefits from MVAIC. The Appellate Term, Second Department, found that the assignor was neither a qualified person under Insurance Law § 5202 (b) nor a covered person under Insurance Law § 5221 (b) (2), leaving a condition precedent unsatisfied.
- Complete Med. Servs. of N.Y., P.C. v MVAIC (2008 NY Slip Op 51541(U))A provider that knows the identities of the driver and vehicle owner must exhaust its remedies against them before seeking relief from MVAIC. The assignor was struck by a taxicab whose driver and owner were known, making the provider's claim against MVAIC premature.
- M.N.M. Med. Health Care, P.C. v MVAIC (2009 NY Slip Op 50041(U))MVAIC established that the assignor failed to file a timely notice of claim, defeating coverage for the provider's assigned claim.
- Advanced Chiropractic of NY, P.C. v MVAIC (2017 NY Slip Op 50955(U))The provider failed to prove the assignor's New York residency and the absence of other available insurance coverage for its MVAIC claim.