May 6, 2015

Longevity Med. Supply, Inc. v Allstate Ins. Co. (2015 NY Slip Op 50757(U))

https://www.beynensonlaw.com/case-law/longevity-med-supply-inc-v-allstate-ins-co-2015-ny-slip-op50757u/

Court: Appellate Term, Second Department
Decided: May 6, 2015
Citation: 2015 NY Slip Op 50757(U) · 47 Misc 3d 147(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Verification requests
Legal questions: Outstanding verification and premature actions (see the maps)

Cite as

Longevity Med. Supply, Inc. v Allstate Ins. Co., 47 Misc 3d 147(A), 2015 NY Slip Op 50757(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015)

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 failed to eliminate a factual issue about whether it had served responses to the insurer's verification requests. Civil Court, Kings County, found timely mailing of requests for additional verification and identified service of responses as the only trial issue. The insurer submitted proof that it had not received the requested verification, while the provider submitted an affidavit asserting that responsive material had been sent. Considering both submissions, the Appellate Term, Second Department, concluded that the provider had not shown the absence of a material factual dispute. It affirmed the order, insofar as appealed from, denying the provider's summary judgment motion.

Reported in New York Official Reports at Longevity Med. Supply, Inc. v Allstate Ins. Co. (2015 NY Slip Op 50757(U))

[*1]

Longevity Med. Supply, Inc. v Allstate Ins. Co.

2015 NY Slip Op 50757(U) [47 Misc 3d 147(A)]

Decided on May 6, 2015

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This opinion is uncorrected and will not be published in the printed Official Reports.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 6, 2015

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

PRESENT: : PESCE, P.J., SOLOMON and ELLIOT, JJ.
2013-2435 K C

Longevity Medical Supply, Inc. as Assignee of ANA CABRAL, Appellant,
against
Allstate Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Wavny Toussaint, J.), entered September 5, 2013. The order, insofar as appealed from and as limited by the brief, denied plaintiff’s motion for summary judgment.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals, as limited by its brief, from so much of an order as denied its motion for summary judgment. The Civil Court determined that defendant had established that it had timely mailed requests for additional verification, and found that the only issue for trial is whether plaintiff had served responses to defendant’s verification requests.

The record shows that the Civil Court considered both defendant’s proof that defendant had not received requested verification from plaintiff and an affidavit from plaintiff which asserts that material responsive to the verification requests had been sent to defendant. Thus, plaintiff failed to establish the absence of a material issue of fact. As a result, the Civil Court properly determined that plaintiff was not entitled to summary judgment. Plaintiff’s remaining contentions lack merit.

Accordingly, the order, insofar as appealed from, is affirmed.

Pesce, P.J., Solomon and Elliot, JJ., concur.

Decision Date: May 06, 2015

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.

Outstanding verification and premature actions

Open the full map

Did unanswered verification requests make the provider’s claim premature, or justify denying it for nonresponse?

This decision: Fact issues remain on whether the verification defense applies

Held the provider not entitled to summary judgment because the insurer's proof of nonreceipt and the provider's affidavit that responsive material was sent raised an issue of fact whether verification was provided.

Premature: verification outstandingNonresponse denial upheldTriable issueInsurer's showing failsProvider compliedThis decision

Of the 385 decisions on this question in the Second Department courts and the Court of Appeals, 114 (this one included) are in the same category.

Similar decisions

Longevity Med. Supply, Inc. v Farmington Cas. Co. (2019 NY Slip Op 51626(U))The provider's sole challenge to the insurer's summary judgment motion was unpreserved because it was raised for the first time on appeal.
Longevity Med. Supply, Inc. v State Farm Mut. Auto. Ins. Co. (2022 NY Slip Op 51235(U))The insurer established that it had already paid another provider for the same medical equipment underlying the disputed claim.
Longevity Med. Supply, Inc. v Praetorian Ins. Co. (2015 NY Slip Op 50401(U))The provider proved its first claim, while its verification-mailing affidavit raised a factual issue on whether the second claim was premature.
Longevity Med. Supply, Inc. v Travelers Prop. & Cas. Ins. Co. (2019 NY Slip Op 51956(U))A Civil Court summary judgment motion is timely when mailed to opposing counsel within 120 days after the notice of trial is filed.
Ultimate Health Prods., Inc. v Allstate Ins. Co. (2016 NY Slip Op 51353(U))The insurer failed to establish timely mailing of verification requests, requiring vacatur of a finding under CPLR 3212 (g).