May 18, 2015

New Way Med. Supply Corp. v National Liab. & Fire Ins. Co. (2015 NY Slip Op 50783(U))

Headnote

The court considered the case of New Way Medical Supply Corp. as Assignee of Junie Sully Moliere v National Liability & Fire Insurance Company, where the plaintiff sought to recover assigned first-party no-fault benefits. The main issue was whether the plaintiff had responded to the defendant's requests for verification, as a claim need not be paid or denied until all demanded verification is provided. The court held that since there was a triable issue of fact as to whether the plaintiff responded to the verification requests, neither party was entitled to summary judgment. Therefore, the court modified the order by denying the defendant's cross motion for summary judgment dismissing the complaint. The remaining contention of the plaintiff was found to lack merit.

Reported in New York Official Reports at New Way Med. Supply Corp. v National Liab. & Fire Ins. Co. (2015 NY Slip Op 50783(U))

New Way Med. Supply Corp. v National Liab. & Fire Ins. Co. (2015 NY Slip Op 50783(U)) [*1]

New Way Med. Supply Corp. v National Liab. & Fire Ins. Co.

2015 NY Slip Op 50783(U) [47 Misc 3d 150(A)]

Decided on May 18, 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This opinion is uncorrected and will not be published in the printed Official Reports.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 18, 2015

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-15 Q C

New Way Medical Supply Corp. as Assignee of JUNIE SULLY MOLIERRE, Appellant,
against
National Liability & Fire Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Richard G. Latin, J.), entered November 21, 2012. The order denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied; as so modified, the order is affirmed, without costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.

Since a claim need not be paid or denied until all demanded verification with respect thereto is provided (see Westchester County Med. Ctr. v New York Cent. Mut. Fire Ins. Co., 262 AD2d 553, 554 [1999]), any action to recover payment is premature when the provider has failed to respond to a request for verification (see Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492, 493 [2005]). In support of its cross motion, defendant demonstrated it had timely mailed initial and follow-up requests for verification (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]). However, upon the record before us, we find that there is a triable issue of fact as to whether plaintiff responded to those verification requests and, therefore, neither party is entitled to summary judgment (see Zuckerman v City of New York, 49 NY2d 557 [1980]).

Plaintiff’s remaining contention lacks merit.

Accordingly, the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied.

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

Decision Date: May 18, 2015