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October 2, 2006

Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co. (2006 NY Slip Op 51877(U))

https://www.beynensonlaw.com/case-law/delta-diagnostic-radiology-p-c-v-country-wide-ins-co-2006-ny-slip-op-51877u/

Court
Appellate Term, Second Department
Decided
October 2, 2006
Citation
2006 NY Slip Op 51877(U) · 13 Misc 3d 132(A)
Posture
Summary judgment
Later treatment
Followed in 1 later decision (see Cited by)
Issues
Discovery and procedure Provider's prima facie case
Legal questions
Claimant's prima facie case on motions (see the maps)
Cite as
Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co., 13 Misc 3d 132(A), 2006 NY Slip Op 51877(U) (App Term, 2d Dept, 2d & 11th Jud Dists 2006)

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 provider's summary judgment appeal was held in abeyance because the motion court and appellate record differed about its affidavit. The motion court denied judgment with leave to renew, describing the corporate officer's affidavit as signed in blank and undated. The appellate record contained a signed, dated affidavit. Although the provider's supporting statements did not establish submission of the claims, the insurer's attached denials acknowledged receipt and ordinarily cured that deficiency in the prima facie showing under Insurance Law § 5106 (a). The Appellate Term, Second Department, remanded to the Civil Court, Queens County, for a report on whether the affidavit in the appellate record was the same one considered on the motion.

Reported in New York Official Reports at Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co. (2006 NY Slip Op 51877(U))

[*1]
Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co.
2006 NY Slip Op 51877(U) [13 Misc 3d 132(A)]
Decided on October 2, 2006
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This opinion is uncorrected and will not be published in the printed Official Reports.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 2, 2006

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 2nd and 11th JUDICIAL DISTRICTS


PRESENT:: PESCE, P.J., WESTON PATTERSON and BELEN, JJ
2005-1692 Q C.
Delta Diagnostic Radiology, P.C. AAO SUNG KWON, Appellant,

against

Country-Wide Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Timothy J. Dufficy, J.), entered August 11, 2005. The order denied plaintiff’s motion for summary judgment with leave to renew upon the submission of proper papers.

Appeal held in abeyance and matter remanded to the court below to report whether the affidavit of plaintiff’s corporate officer included in plaintiff’s summary judgment motion papers as part of the record on appeal was the same affidavit as was submitted to the motion court. The Civil Court shall file its report with all convenient speed.

In an action to recover first-party no-fault benefits, a plaintiff establishes its prima facie entitlement to summary judgment by proof of the submission of a statutory claim form, setting forth the fact and the amount of the loss sustained, and that payment of no-fault benefits was overdue (see Insurance Law § 5106 [a]; Mary Immaculate Hosp. v Allstate Ins. Co., 5 AD3d 742 [2004]; Amaze Med. Supply v Eagle Ins. Co., 2 Misc 3d 128[A], 2003 NY Slip Op 51701[U] [App Term, 2d & 11th Jud Dists]).

In the instant case, plaintiff’s motion for summary judgment was supported by an affirmation of counsel and an affidavit of an officer of plaintiff provider, neither of which were sufficient to establish that the claim forms were submitted to defendant. However, plaintiff’s motion papers also contained copies of defendant’s denial of claim forms which acknowledge [*2]receipt of the claims on various specified dates. Such acknowledgment ordinarily cures any deficiencies in the motion papers with respect to the submission of the claim forms (see e.g. Careplus Med. Supply Inc. v State-Wide Ins. Co., 11 Misc 3d 29 [App Term, 2d & 11th Jud Dists 2005]). Nevertheless, the court below based its decision denying plaintiff’s motion for summary judgment, in part, upon the fact that the affidavit of plaintiff’s officer was both “signed in blank” and undated. The record on appeal, however, indicates that the affidavit submitted with the motion papers was signed and sworn to on a particular date.

Because of this discrepancy, we are unable to make a determination as to whether the affidavit submitted to the court below on the motion is the same affidavit as the one subject to review on this appeal. Accordingly, the matter is remanded to the court below to report whether the affidavit contained in the record on appeal was the same affidavit as was considered by the motion court.

Pesce, P.J., Weston Patterson and Belen, JJ., concur.
Decision Date: October 02, 2006

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.

Claimant's prima facie case on motions

Open the full map

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 (rules on the question, but another ground decided the case)

Held the provider's affirmation and affidavit did not show submission, but the insurer's denial forms acknowledging receipt ordinarily cured that deficiency.

  • Court of AppealsCt App 2
  • Appellate DivisionApp Div 80
  • Appellate TermApp Term 843
  • Trial courtsTrial 138
2015, Court of Appeals: 1 decision (1 Proof sufficient)2007, Court of Appeals: 1 decision (1 Proof sufficient)2022, Appellate Division: 1 decision (1 Proof sufficient)2019, Appellate Division: 1 decision (1 Proof sufficient)2014, Appellate Division: 10 decisions (9 Proof sufficient, 1 Overdue not shown)2013, Appellate Division: 2 decisions (2 Proof sufficient)2012, Appellate Division: 2 decisions (2 Proof sufficient)2011, Appellate Division: 11 decisions (11 Proof sufficient)2010, Appellate Division: 3 decisions (2 Proof sufficient, 1 Overdue not shown)2009, Appellate Division: 3 decisions (2 Proof sufficient, 1 Other element missing)2008, Appellate Division: 8 decisions (6 Proof sufficient, 1 Overdue not shown, 1 Business-record foundation lacking)2007, Appellate Division: 15 decisions (12 Proof sufficient, 2 Mailing/receipt not shown, 1 Overdue not shown)2006, Appellate Division: 5 decisions (3 Proof sufficient, 1 Mailing/receipt not shown, 1 Other element missing)2005, Appellate Division: 5 decisions (5 Proof sufficient)2004, Appellate Division: 11 decisions (10 Proof sufficient, 1 Overdue not shown)2026, Appellate Division: 1 decision (1 Proof sufficient)2003, Appellate Division: 2 decisions (1 Proof sufficient, 1 Overdue not shown)2022, Appellate Term: 14 decisions (2 Mailing/receipt not shown, 12 Overdue not shown)2021, Appellate Term: 5 decisions (1 Proof sufficient, 4 Overdue not shown)2020, Appellate Term: 13 decisions (13 Overdue not shown)2019, Appellate Term: 23 decisions (22 Overdue not shown, 1 Other element missing)2018, Appellate Term: 26 decisions (3 Proof sufficient, 1 Mailing/receipt not shown, 22 Overdue not shown)2017, Appellate Term: 38 decisions (3 Proof sufficient, 1 Mailing/receipt not shown, 34 Overdue not shown)2016, Appellate Term: 41 decisions (7 Proof sufficient, 34 Overdue not shown)2015, Appellate Term: 44 decisions (12 Proof sufficient, 1 Mailing/receipt not shown, 30 Overdue not shown, 1 Business-record foundation lacking)2014, Appellate Term: 22 decisions (10 Proof sufficient, 12 Overdue not shown)2013, Appellate Term: 34 decisions (17 Proof sufficient, 11 Overdue not shown, 6 Business-record foundation lacking)2012, Appellate Term: 32 decisions (3 Proof sufficient, 2 Mailing/receipt not shown, 11 Overdue not shown, 16 Business-record foundation lacking)2011, Appellate Term: 29 decisions (6 Proof sufficient, 1 Mailing/receipt not shown, 13 Overdue not shown, 9 Business-record foundation lacking)2010, Appellate Term: 36 decisions (22 Proof sufficient, 3 Mailing/receipt not shown, 10 Business-record foundation lacking, 1 Other element missing)2009, Appellate Term: 52 decisions (28 Proof sufficient, 3 Mailing/receipt not shown, 21 Business-record foundation lacking)2008, Appellate Term: 49 decisions (16 Proof sufficient, 1 Mailing/receipt not shown, 32 Business-record foundation lacking)2007, Appellate Term: 104 decisions (8 Proof sufficient, 2 Mailing/receipt not shown, 94 Business-record foundation lacking)2006, Appellate Term: 112 decisions (76 Proof sufficient, 26 Mailing/receipt not shown, 1 Overdue not shown, 6 Business-record foundation lacking, 3 Other element missing)2005, Appellate Term: 90 decisions (84 Proof sufficient, 5 Mailing/receipt not shown, 1 Overdue not shown)2004, Appellate Term: 57 decisions (43 Proof sufficient, 10 Mailing/receipt not shown, 4 Other element missing)2003, Appellate Term: 7 decisions (7 Proof sufficient)2023, Appellate Term: 3 decisions (3 Overdue not shown)2024, Appellate Term: 7 decisions (1 Mailing/receipt not shown, 6 Overdue not shown)2025, Appellate Term: 3 decisions (1 Proof sufficient, 1 Mailing/receipt not shown, 1 Overdue not shown)2026, Appellate Term: 2 decisions (2 Mailing/receipt not shown)2023, Trial courts: 2 decisions (2 Proof sufficient)2022, Trial courts: 4 decisions (2 Proof sufficient, 2 Overdue not shown)2021, Trial courts: 11 decisions (6 Proof sufficient, 2 Mailing/receipt not shown, 2 Overdue not shown, 1 Other element missing)2020, Trial courts: 5 decisions (3 Proof sufficient, 1 Overdue not shown, 1 Other element missing)2019, Trial courts: 6 decisions (5 Proof sufficient, 1 Mailing/receipt not shown)2018, Trial courts: 2 decisions (2 Overdue not shown)2017, Trial courts: 3 decisions (1 Proof sufficient, 1 Overdue not shown, 1 Other element missing)2016, Trial courts: 4 decisions (4 Proof sufficient)2013, Trial courts: 1 decision (1 Proof sufficient)2012, Trial courts: 5 decisions (4 Proof sufficient, 1 Business-record foundation lacking)2011, Trial courts: 3 decisions (2 Proof sufficient, 1 Business-record foundation lacking)2010, Trial courts: 3 decisions (2 Proof sufficient, 1 Business-record foundation lacking)2009, Trial courts: 7 decisions (7 Proof sufficient)2008, Trial courts: 14 decisions (8 Proof sufficient, 1 Mailing/receipt not shown, 1 Overdue not shown, 4 Business-record foundation lacking)2007, Trial courts: 7 decisions (5 Proof sufficient, 2 Business-record foundation lacking)2006, Trial courts: 16 decisions (13 Proof sufficient, 2 Overdue not shown, 1 Other element missing)2005, Trial courts: 22 decisions (14 Proof sufficient, 5 Mailing/receipt not shown, 3 Business-record foundation lacking)2004, Trial courts: 14 decisions (8 Proof sufficient, 2 Mailing/receipt not shown, 4 Other element missing)2025, Trial courts: 2 decisions (1 Proof sufficient, 1 Mailing/receipt not shown)2026, Trial courts: 4 decisions (3 Proof sufficient, 1 Mailing/receipt not shown)2014, Trial courts: 1 decision (1 Proof sufficient)2015, Trial courts: 1 decision (1 Proof sufficient)2024, Trial courts: 1 decision (1 Proof sufficient)This decision
20052010201520202025
Proof sufficientMailing/receipt not shownOverdue not shownBusiness-record foundation lackingOther element missingThis decisionCites it or cited by itCited or followed

Of the 1,063 decisions on this question in the Second Department courts and the Court of Appeals, 511 (this one included) are in the same category.

Cited in this decision

  • Mary Immaculate Hosp. v Allstate Ins. Co. (2004 NY Slip Op 02359)The hospitals established entitlement to summary judgment by proving that statutory billing forms were mailed and received and payment was overdue.
  • Amaze Med. Supply v Eagle Ins. Co. (2003 NY Slip Op 51701(U))A provider's completed claim forms establish its prima facie case without additional medical proof when the insurer is precluded.
  • Careplus Med. Supply Inc. v State-Wide Ins. Co. (2005 NY Slip Op 25545)The insurer's completed denial form established receipt of the provider's claims and showed that the denial was untimely.

Cited by

A label shows how the later decision treated this one.

  • Elmont Open MRI & Diagnostic Radiology, P.C. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 22242) FollowedThe provider proved mailing of requested verification, and the insurer's conclusory denial of receipt raised no triable issue.

Similar decisions

  • Delta Diagnostic Radiology, P.C. v Statewide Ins. Co. (2007 NY Slip Op 50677(U))The provider's officer affidavit failed to establish a business-records foundation, leaving its prima facie summary judgment showing deficient.
  • Delta Diagnostic Radiology, P.C. v Allstate Ins. Co. (2007 NY Slip Op 50246(U))The provider's corporate officer affidavit failed to establish the business-records foundation needed for a prima facie case.
  • Delta Diagnostic Radiology, P.C. v General Assur. Co. (2007 NY Slip Op 51616(U))The provider failed to establish a prima facie case because its corporate officer did not lay a foundation for the attached business records.
  • Delta Diagnostic Radiology, P.C. v Progressive Cas. Ins. Co. (2007 NY Slip Op 51487(U))The provider's conclusory affidavit failed to establish an admissible business-records basis for summary judgment.
  • Delta Diagnostic Radiology, P.C. v American Tr. Ins. Co. (2007 NY Slip Op 50238(U))The provider's conclusory corporate officer affidavit did not establish a business-records foundation for summary judgment.
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