April 2, 2012

Complete Radiology, P.C. v Progressive Ins. Co. (2012 NY Slip Op 50583(U))

Headnote

The relevant facts considered by the court were that Complete Radiology, P.C. was appealing from an order which denied its motion for summary judgment in an action to recover assigned first-party no-fault benefits from Progressive Insurance Company. The main issue decided in this case was whether the provider had established its entitlement to summary judgment by proof of submission of a claim form, proof of the fact and the amount of the loss sustained, and proof either that the defendant had failed to pay or deny the claim within the requisite 30-day period, or that the defendant had issued a timely denial of claim that was conclusory, vague or without merit as a matter of law. The holding of the court was that the provider's affidavit failed to state unequivocally that defendant's denial of claim forms were either untimely or without merit as a matter of law, and thus the order denying the motion for summary judgment was affirmed.

Reported in New York Official Reports at Complete Radiology, P.C. v Progressive Ins. Co. (2012 NY Slip Op 50583(U))

Complete Radiology, P.C. v Progressive Ins. Co. (2012 NY Slip Op 50583(U)) [*1]

Complete Radiology, P.C. v Progressive Ins. Co.

2012 NY Slip Op 50583(U) [35 Misc 3d 127(A)]

Decided on April 2, 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This opinion is uncorrected and will not be published in the printed Official Reports.

Decided on April 2, 2012

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

PRESENT: : PESCE, P.J., WESTON and RIOS, JJ
2010-2941 Q C.

Complete Radiology, P.C. as Assignee of ROBERT BAGADASROV, Appellant, – –
against
Progressive Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Genine D. Edwards, J.), entered September 29, 2010. The order denied plaintiff’s motion for summary judgment.

ORDERED that the order is affirmed, without costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order which denied its unopposed motion for summary judgment.

A no-fault provider establishes its prima facie entitlement to summary judgment by proof of the submission to the defendant of a claim form, proof of the fact and the amount of the loss sustained, and proof either that the defendant had failed to pay or deny the claim within the requisite 30-day period, or that the defendant had issued a timely denial of claim that was conclusory, vague or without merit as a matter of law (see Insurance Law § 5106 [a]; Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]; Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128[A], 2011 NY Slip Op 51292[U] [App Term, 2d, 11th & 13th Jud Dists 2011]). Here, plaintiff’s affidavit failed to state unequivocally that defendant’s denial of claim forms were either untimely or without merit as a matter of law.

Accordingly, the order is affirmed. [*2]

Pesce, P.J., Weston and Rios, JJ., concur.
Decision Date: April 02, 2012