October 22, 2010

New Millenium Med. Supply v Clarendon Natl. Ins. Co. (2010 NY Slip Op51820(U))

https://www.beynensonlaw.com/case-law/new-millenium-med-supply-v-clarendon-natl-ins-co-2010-ny-slip-op51820u/

Court: Appellate Term, First Department
Decided: October 22, 2010
Citation: 2010 NY Slip Op 51820(U) · 29 Misc 3d 130(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Statute of limitations
Legal questions: No-fault statute of limitations (see the maps)

Cite as

New Millenium Med. Supply v Clarendon Natl. Ins. Co., 29 Misc 3d 130(A), 2010 NY Slip Op 51820(U) (App Term, 1st Dept 2010)

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.

A claim for no-fault benefits under an insurance policy accrues when payment becomes overdue, rather than upon an untimely denial. The Appellate Term, First Department, reversed denial of the insurer's summary judgment motion and dismissed the provider's complaint as barred by the six-year limitations period. Under Insurance Law § 5106 (a) and 11 NYCRR 65-3.8 (a) (1), this claim became overdue 30 days after receipt. The provider's reliance on Matter of Taggart v State Farm Mut. Auto. Ins. Co. was misplaced because that decision concerned a general denial terminating benefits for lack of continuing disability under former 11 NYCRR 65.15 (g) (2) (ii), now 65-3.8 (b) (2), rather than a specific submitted claim.

Reported in New York Official Reports at New Millenium Med. Supply v Clarendon Natl. Ins. Co. (2010 NY Slip Op 51820(U))

[*1]

New Millenium Med. Supply v Clarendon Natl. Ins. Co.

2010 NY Slip Op 51820(U) [29 Misc 3d 130(A)]

Decided on October 22, 2010

Appellate Term, First 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This opinion is uncorrected and will not be published in the printed Official Reports.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 October 22, 2010

APPELLATE TERM OF THE SUPREME COURT, FIRST DEPARTMENT

PRESENT: McKeon, P.J., Schoenfeld, Hunter, Jr., JJ
570112/10.

New Millenium Medical Supply a/a/o Gibson Stayman, Plaintiff-Respondent,
against
Clarendon National Insurance Company, Defendant-Appellant.

McKeon, P.J., Schoenfeld, Hunter, Jr., JJ.

New Millenium Medical SupplyNY County Clerk’s No. 570112/10 a/a/o Gibson Stayman, Plaintiff-Respondent, against Calendar No. 10-106 Clarendon National Insurance Company, Defendant-Appellant. Defendant appeals from an order of the Civil Court of the City of New York, New York County (Peter H. Moulton, J.), dated April 23, 2009, which denied its motion for summary judgment dismissing the complaint. Per Curiam. Order (Peter H. Moulton, J.), dated April 23, 2009, reversed, with $10 costs, motion granted and complaint dismissed. The Clerk is directed to enter judgment accordingly. Plaintiff’s cause of action to recover assigned first-party no-fault benefits pursuant to a policy of insurance was not interposed within the applicable six-year statute of limitations (see Mandarino v Travelers Property Cas. Ins. Co., 37 AD3d 775 [2007]), since the cause of action accrued on the date the claim became overdue — here, 30 days after defendant’s receipt of the claim — not the date of defendant’s untimely denial of the claim (see Matter of Travelers Indem. Co. of Conn. v Glenwood Med., P.C., 48 AD3d 319 [2008]; Benson v Boston Old Colony Ins. Co., 134 AD2d 214 [1987], lv denied 71 NY2d 801 [1988]). Plaintiff’s reliance on Matter of Taggart v State Farm Mut. Auto. Ins. Co. (272 AD2d 222 [2000]) is misplaced, since that case involved a general denial of claim issued under 11 NYCRR 65.15(g)(2)(ii) (now 65-3.8[b][2]) terminating no-fault benefits on the ground that the claimant was no longer disabled, while the matter at bar involves the factually and legally distinct situation in which a specific claim for no-fault benefits has been submitted to an insurer for payment or denial. Therefore, the complaint should have been dismissed as time-barred (see Insurance Law § 5106[a]; 11 NYCRR 65-3.8[a][1]; Matter of Travelers Indem. Co. of Conn., supra; Benson, supra). THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT. Decision Date: October 22, 2010

10/22/2010
SUPREME COURT, APPELLATE TERM, FIRST DEPARTMENT

								April 2010 Term

Defendant appeals from an order of the Civil Court of the City of New York, New York County (Peter H. Moulton, J.), dated April 23, 2009, which denied its motion for summary judgment dismissing the complaint.

Per Curiam.

Order (Peter H. Moulton, J.), dated April 23, 2009, reversed, with $10 costs, motion granted and complaint dismissed. The Clerk is directed to enter judgment accordingly.

Plaintiff’s cause of action to recover assigned first-party no-fault benefits pursuant to a policy of insurance was not interposed within the applicable six-year statute of limitations (see Mandarino v Travelers Property Cas. Ins. Co., 37 AD3d 775 [2007]), since the cause of action accrued on the date the claim became overdue — here, 30 days after defendant’s receipt of the claim — not the date of defendant’s untimely denial of the claim (see Matter of Travelers Indem. Co. of Conn. v Glenwood Med., P.C., 48 AD3d 319 [2008]; Benson v Boston Old Colony Ins. Co., 134 AD2d 214 [1987], lv denied 71 NY2d 801 [1988]). Plaintiff’s reliance on Matter of Taggart v State Farm Mut. Auto. Ins. Co. (272 AD2d 222 [2000]) is misplaced, since that case involved a general denial of claim issued under 11 NYCRR 65.15(g)(2)(ii) (now 65-3.8[b][2]) terminating no-fault benefits on the ground that the claimant was no longer disabled, while the matter at bar involves the factually and legally distinct situation in which a specific claim for no-fault benefits has been submitted to an insurer for payment or denial. Therefore, the complaint should have been dismissed as time-barred (see Insurance Law § 5106[a]; 11 NYCRR 65-3.8[a][1]; Matter of Travelers Indem. Co. of Conn., supra; Benson, supra).

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
Decision Date: October 22, 2010

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.

No-fault statute of limitations

Open the full map

Which limitations period governs a first-party no-fault claim against an insurer, self-insurer or MVAIC: six or three years?

This decision: Claim against an insurer under a policy carries the six-year contract period (CPLR 213 [2]) (rules on the question, but another ground decided the case)

Held the claim under the insurance policy barred by the six-year period, because it accrued 30 days after the insurer received the claim, not on the date of its untimely denial.

Six years: insurerSix years: self-insurerThree years: self-insurerThree years: MVAICThis decisionCites it or cited by itCited or followed

Of the 11 decisions on this question in the First Department courts and the Court of Appeals, 3 (this one included) are in the same category. One decision in other departments that cites or is cited by this one is on the full map.

Cited in this decision

A label shows how this decision treated the case it cites.

Mandarino v Travelers Prop. Cas. Ins. Co. (2007 NY Slip Op 01693) FollowedA provider's action to recover no-fault benefits under an insurance policy is governed by the six-year contractual limitations period.
Matter of Travelers Indem. Co. of Conn. v Glenwood Med., P.C. (2008 NY Slip Op 01598)An insurer's reconsideration of a denied no-fault claim does not extend the claim's accrual date for statute-of-limitations purposes.

Similar decisions

MDJ Med., P.C. v New York Cent. Mut. Ins. Co. (2013 NY Slip Op 51797(U))An assignor's failure to attend requested IMEs permits denial of all claims retroactively to the loss date, regardless of denial timing.
DJS Med. Supplies, Inc. v Clarendon Natl. Ins. Co. (2011 NY Slip Op 51304(U))A no-fault claim accrues 30 days after the insurer receives it; a later denial does not postpone accrual.
Midtown Med. Assoc., P.C. v Clarendon Natl. Ins. Co. (2012 NY Slip Op 51351(U))The insurer established payment of one claim, untimely submission of three claims, and lack of medical necessity for the remaining services.
Magenta Med. P.C. v Clarendon Natl. Ins. Co. (2012 NY Slip Op 52236(U))The provider failed to raise a factual issue as to timely submission of its no-fault claim or reasonable justification for its delay.
New Millennium Med. Imaging, P.C. v American Tr. Ins. Co. (2017 NY Slip Op 51088(U))The insurer's late opposition papers were properly considered and raised a factual issue as to whether the claims had been timely denied.