Metroscan Med. Diagnostics, P.C. v Progressive Cas. Ins. Co. (2007 NY Slip Op 50500(U))

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 9th and 10th JUDICIAL DISTRICTS

Appeal from an order of the District Court of Nassau County, First District (Sondra K. Pardes, J.), dated August 29, 2005. The order granted defendant’s motion for summary judgment dismissing the complaint.

Order affirmed without costs.

In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint, asserting, inter alia, that the action was premature as defendant’s time to pay or deny the claim was tolled due to plaintiff’s failure to adequately respond to initial and follow-up verification requests. By order dated August 29, 2005, the lower court agreed and granted defendant’s motion. The instant appeal by plaintiff ensued.

After receipt of plaintiff’s claim which was accompanied by an incomplete assignment of benefits form, defendant requested verification in the form of a copy of a proper assignment. In response, plaintiff sent an incomplete assignment. As a result, defendant served a follow-up verification request seeking a completed assignment. Since plaintiff has yet to provide defendant with an assignment executed by plaintiff’s assignor which, as required by the assignment of benefits form contained within the regulations promulgated by the New York State Insurance Department, sets forth, among other things, the date of the accident, the assignor’s address and the date that the form was signed, the 30-day statutory period in which defendant has to pay or deny the claim has been tolled (see New York Hosp. Med. Ctr. of Queens v Country-Wide Ins. Co. , 295 AD2d 583 [2002]; Doshi Diagnostic Imagining Servs. v Progressive Ins. Co., 12 Misc 3d 144[A], 2006 NY Slip Op 51430[U] [App Term, 9th & 10th Jud Dists]). Consequently, [*2]defendant has established that payment of no-fault benefits is not overdue and that the action is premature (see Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492, 493 [2005]).

Plaintiff’s contention that the verification requests lacked specificity and failed to advise plaintiff what documentation it needed to supply to defendant is lacking in merit (see generally Westchester County Med. Ctr. v New York Cent. Mut. Fire Ins. Co., 262 AD2d 553 [1999]). Indeed, the record establishes that plaintiff responded to the first verification request by re-submitting an assignment of benefits form which, as previously noted, was not properly completed. In addition, in its opposition papers, plaintiff’s attorney stated that the second verification request was unnecessary and was an attempt by defendant to harass plaintiff.

In light of the foregoing, the court below properly granted defendant’s motion for summary judgment dismissing the complaint (see Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d at 493).
Rudolph, P.J., Tanenbaum and LaCava, JJ., concur.
Decision Date: March 15, 2007