February 1, 2013

Quality Psychological Servs., P.C. v Utica Mut. Ins. Co. (2013 NY Slip Op 50148(U))

Headnote

The court considered the untimely request for additional verification from the defendant, in the form of an examination under oath (EUO) of the plaintiff medical provider. The main issue decided was whether the defendant's request for additional verification was untimely and did not serve to toll the defendant's time to pay or deny the claim. The holding of the case was that the denial of the defendant's motion for summary judgment dismissing the first-party no-fault action was sustained because the request for additional verification was made well beyond the requisite 15-day time period following the assignor's EUO, as per 11 NYCRR 65-3.5[b] and 65—3.8[a][1]. Therefore, the denial of the defendant's motion was affirmed, and the decision and order of the court constituted the final ruling.

Reported in New York Official Reports at Quality Psychological Servs., P.C. v Utica Mut. Ins. Co. (2013 NY Slip Op 50148(U))

Quality Psychological Servs., P.C. v Utica Mut. Ins. Co. (2013 NY Slip Op 50148(U)) [*1]

Quality Psychological Servs., P.C. v Utica Mut. Ins. Co.

2013 NY Slip Op 50148(U) [38 Misc 3d 136(A)]

Decided on February 1, 2013

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This opinion is uncorrected and will not be published in the printed Official Reports.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 February 1, 2013

SUPREME COURT, APPELLATE TERM, FIRST DEPARTMENT

PRESENT: Lowe, III, P.J., Schoenfeld, Hunter, Jr., JJ
570808/12.

Quality Psychological Services, P.C., a/a/o Marlon McLeod, Plaintiff-Respondent, – –
against
Utica Mutual Insurance Company, Defendant-Appellant.

Defendant appeals from an order of the Civil Court of the City of New York, Bronx County (Robert R. Reed, J.), entered April 18, 2011, which denied its motion for summary judgment dismissing the complaint.

Per Curiam.

Order (Robert R. Reed, J.), entered April 18, 2011, affirmed, with $10 costs.

We sustain the denial of defendant’s motion for summary judgment dismissing this first-party no-fault action. Defendant’s June 26, 2008 request for additional verification in the form of an examination under oath (EUO) of the plaintiff medical provider was untimely and did not serve to toll defendant’s time to pay or deny the claim, since the request was made well beyond the requisite 15-day time period following the assignor’s EUO (see 11 NYCRR 65-3.5[b]; 65—3.8[a][1]; see Kingsbrook Jewish Med. Ctr. v Allstate Ins. Co., 61 AD3d 13, 17-18 [2009]).

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
Decision Date: February 01, 2013