May 8, 2009

Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co. (2009 NY Slip Op 52501(U))

Headnote

The main issue in this case was whether Delta Diagnostic Radiology, P.C. was entitled to recover assigned first-party no-fault benefits from Country-Wide Insurance Company. The court considered the fact that Country-Wide Insurance Company's follow-up verification requests were premature and without effect, and thus denied the defendant's motion for summary judgment. The holdng of the case was that defendant's motion for summary judgment was properly denied because of the premature and ineffective follow-up verification requests, which violated General Construction Law § 20 and Insurance Department Regulations. The court affirmed the order without costs, with one judge dissenting.

Reported in New York Official Reports at Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co. (2009 NY Slip Op 52501(U))

Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co. (2009 NY Slip Op 52501(U)) [*1]

Delta Diagnostic Radiology, P.C. v Country-Wide Ins. Co.

2009 NY Slip Op 52501(U) [25 Misc 3d 142(A)]

Decided on May 8, 2009

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This opinion is uncorrected and will not be published in the printed Official Reports.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 May 8, 2009

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 2nd, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : PESCE, P.J., GOLIA and RIOS, JJ
2007-1327 Q C.

Delta Diagnostic Radiology, P.C. as assignee of O’NEAL DIXON, Respondent,
against
Country-Wide Insurance Company, Appellant.

Appeal from an order of the Civil Court of the City of New York, Queens County (Diane A. Lebedeff, J.), entered August 1, 2007. The order denied defendant’s motion for summary judgment.

Order affirmed without costs.

In this action by a provider to recover assigned first-party no-fault benefits, the court denied defendant’s motion for summary judgment. Defendant appeals and we affirm.

Defendant’s follow-up verification requests, mailed on the 30th calendar day after it mailed the verification requests, were premature and without effect (see
General Construction Law § 20; Insurance Department Regulations [11 NYCRR] § 65-3.6 [b]; St. Vincent Med. Care, P.C. v Country-Wide Ins. Co., ___ Misc 3d ___, 2009 NY Slip Op _____ [No. 2008-437 Q C], decided herewith; Infinity Health Prods., Ltd. v Eveready Ins. Co., 21 Misc 3d 1 [App Term, 2d & 11th Jud Dists 2008]). Accordingly, defendant’s motion for summary judgment was properly denied.

Pesce, P.J., and Rios, J., concur.

Golia, J., dissents in a separate memorandum.

Golia, J., dissents and votes to reverse the order and grant defendant’s motion for summary judgment for the reasons stated in his dissenting opinion in St. Vincent Med. Care, P.C. v Country-Wide Ins. Co., ___ Misc 3d ___, 2009 NY Slip Op _____ [No. 2008-437 Q C], [*2]decided herewith).
Decision Date: May 08, 2009