February 22, 2022
Equilibrium of Life Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50113(U))
https://www.beynensonlaw.com/case-law/equilibrium-of-life-acupuncture-p-c-v-mvaic-2022-ny-slip-op-50113u/
- Court
- Appellate Term, First Department
- Decided
- February 22, 2022
- Citation
- 2022 NY Slip Op 50113(U) · 74 Misc 3d 129(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Later treatment
- Followed in 1 later decision (see Cited by)
- Legal questions
- MVAIC eligibility: qualified covered person (see the maps)
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 Equilibrium of Life Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50113(U))
[*1]| Equilibrium of Life Acupuncture, P.C. v MVAIC |
| 2022 NY Slip Op 50113(U) [74 Misc 3d 129(A)] |
| Decided on February 22, 2022 |
| Appellate Term, First Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| As corrected in part through February 24, 2022; it will not be published in the printed Official Reports. |
Decided on February 22, 2022
SUPREME COURT, APPELLATE TERM, FIRST DEPARTMENT
PRESENT: Edmead, P.J., Brigantti, Silvera, JJ.
570226/21
against
MVAIC, Defendant-Appellant.
Defendant appeals from an order of the Civil Court of the City of New York, New York County (Judy H. Kim, J.), entered February 22, 2021, which denied its motion for summary judgment dismissing the complaint.
Per Curiam.
Order (Judy H. Kim, J.), entered February 22, 2021, reversed, with $10 costs, motion granted, and the complaint dismissed. The Clerk is directed to enter judgment accordingly.
Defendant MVAIC’s submission in support of its motion for summary judgment established, prima facie, that there had been no timely filing of a notice of intention to make claim as required by Insurance Law § 5208(a). Thus, a condition precedent to plaintiff’s right to apply for payment of no-fault benefits from defendant had not been satisfied (see SML Acupuncture P.C. v MVAIC, 55 Misc 3d 138[A], 2017 NY Slip Op 50539[U] [App Term, 1st Dept 2017]).
In opposition, respondent failed to raise any triable issue of fact. MVAIC’s prior denial of the claim on other grounds does not preclude it from asserting a lack of coverage defense (see Central Gen. Hosp. v Chubb Group of Ins. Cos., 90 NY2d 195, 199 [1997]). Matter of State Farm Ins. Co. v Domotor, 266 AD2d 219 (1999), relied upon by Civil Court, involved a waiver of a condition precedent to payment of claims as required under an insurance policy, not a condition precedent to coverage under Insurance Law § 5208.
All concur
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
Clerk of the Court
Decision Date: February 22, 2022
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.
Against MVAIC, was the claimant shown to be a qualified, covered person meeting article 52’s conditions?
This decision: Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that ground
Granted MVAIC summary judgment because it showed no timely notice of intention to make claim was filed under § 5208, and its earlier denial on other grounds did not preclude the lack-of-coverage defense.
Of the 43 decisions on this question in the First Department courts and the Court of Appeals, 11 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- SML Acupuncture P.C. v MVAIC (2017 NY Slip Op 50539(U)) FollowedMVAIC's untimely denial does not preclude a lack-of-coverage defense based on failure to file a timely notice of claim.
Cited by
A label shows how the later decision treated this one.
- Country-Wide Ins. Co. v Yao Jian Ping (2024 NY Slip Op 24033) FollowedAn insurer's global denial does not excuse regulatory requirements to submit a claim form or its substantial equivalent.
Similar decisions
- Brookside Physical Therapy v MVAIC (2021 NY Slip Op 50998(U))MVAIC established that no timely notice of intention to make a claim was filed and that the accident was not reported within 24 hours.
- Bronx Acupuncture Therapy, P.C. v MVAIC (2019 NY Slip Op 51253(U))The provider failed to establish its prima facie case against MVAIC because it did not prove submission of a timely notice-of-claim affidavit.
- Oleg’s Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50593(U))MVAIC established nonreceipt of the notice-of-intention affidavit required for the provider to recover assigned no-fault benefits.
- ZZ Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50589(U))MVAIC established that it had not received the required notice-of-intention affidavit and obtained dismissal of the provider's claims.
- GL Acupuncture, P.C. v MVAIC (2017 NY Slip Op 51866(U))MVAIC established that no timely notice of claim had been filed, leaving a condition precedent to no-fault payment unsatisfied.