December 23, 2011
Jae Ook Park v GEICO Gen. Ins. Co. (2011 NY Slip Op 52379(U))
https://www.beynensonlaw.com/case-law/jae-ook-park-v-geico-gen-ins-co-2011-ny-slip-op-52379u/
- Decided
- December 23, 2011
- Citation
- 2011 NY Slip Op 52379(U) · 34 Misc 3d 134(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Legal questions
- Claimant's prima facie case on motions (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 Jae Ook Park v GEICO Gen. Ins. Co. (2011 NY Slip Op 52379(U))
| Jae Ook Park v GEICO Gen. Ins. Co. |
| 2011 NY Slip Op 52379(U) [34 Misc 3d 134(A)] |
| Decided on December 23, 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
SUPREME COURT OF THE STATE OF NEW YORK
APPELLATE TERM: 2nd, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., GOLIA and STEINHARDT, JJ
2010-2299 K C.
against
GEICO General Insurance Company, Respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Wavny Toussaint, J.), entered October 30, 2009. The order, insofar as appealed from, denied plaintiff’s motion for summary judgment.
ORDERED that the order, insofar as appealed from, is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals
from so much of an order as denied its motion for summary judgment. Because plaintiff failed to
establish that the bill in question was not timely denied, or that the denial was conclusory, vague,
or without merit as a matter of law, plaintiff failed to establish its prima facie case (Westchester Med. Ctr. v Nationwide Mut.
Ins. Co., 78 AD3d 1168 [2010]; Quality Health Prods. v Country-Wide Ins. Co., 30 Misc 3d
143[A], 2011 NY Slip Op 50328[U] [App Term, 2d, 11th & 13th Jud Dists 2011]; see also Nyack Hosp. v Allstate Ins.
Co., 84 AD3d 1331 [2011]; Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 31 Misc 3d
21 [App Term, 2d, 11th & 13th Jud Dists 2011]).
Accordingly, the order, insofar as appealed from, is affirmed.
We decline defendant’s request to search the record and award it summary judgment [*2]dismissing the complaint.
Pesce, P.J., Golia and Steinhardt, JJ., concur.
Decision Date: December 23, 2011
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.
On summary judgment or another pretrial motion, what must a no-fault claimant show to establish its prima facie case?
This decision: Insufficient: claimant did not prove the claim was overdue (not paid or timely denied)
Held the provider failed its prima facie case because it did not establish that the bill was not timely denied or that the denial was conclusory, vague or without merit as a matter of law.
Of the 1,065 decisions on this question in the Second Department courts and the Court of Appeals, 247 (this one included) are in the same category.
Cited in this decision
- Westchester Med. Ctr. v Nationwide Mut. Ins. Co. (2010 NY Slip Op 08933)The provider failed to establish entitlement to summary judgment because the insurer partially paid and denied the claim within 30 days.
- Quality Health Prods. v Country-Wide Ins. Co. (2011 NY Slip Op 50328(U))The provider failed to establish that its unpaid claim was denied late or that the denial's basis lacked legal merit.
- Nyack Hosp. v Allstate Ins. Co. (2011 NY Slip Op 04644)An insurer's untimely denial precludes a policy exclusion defense based on the assignor's allegedly intentional self-injury.
- Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co. (2011 NY Slip Op 21039)The provider failed to establish its prima facie case because its third-party biller's affidavit lacked a business-record foundation.
Similar decisions
- Parkview Med. & Surgical, P.C. v Geico Gen. Ins. Co. (2014 NY Slip Op 51270(U))The insurer's summary judgment cross motion based on lack of medical necessity remained denied on appeal.
- Parkway Med. Care, P.C. v GEICO Gen. Ins. Co. (2018 NY Slip Op 51005(U))The insurer's unrebutted peer review established lack of medical necessity, and the provider's discovery inaction did not defeat summary judgment.
- A.B. Med., PLLC v GEICO (2013 NY Slip Op 50203(U))The provider failed to establish that the insurer's denials were untimely or without merit as a matter of law.
- New York Diagnostic Med. Care, P.C. v GEICO Cas. Ins. Co. (2012 NY Slip Op 52409(U))The provider's billing affidavit failed to establish overdue claims or timely denials that were legally deficient.
- New York Diagnostic Med. Care, P.C. v Geico Gen. Ins. Co. (2014 NY Slip Op 51808(U))The provider failed to establish that the insurer's denials were untimely or legally insufficient, defeating its prima facie showing.