November 26, 2010

St. Vincent’s Hosp. & Med. Ctr. v American Tr. Ins. Co. (2010 NY Slip Op 52063(U))

Headnote

The Court considered a case involving an action to recover assigned first-party no-fault benefits, where the plaintiff moved for summary judgment upon the first and second causes of action, and the defendant cross-moved for summary judgment dismissing those causes of action on the ground of failure to comply with verification requests. The main issue decided was whether the defendant had established the mailing of its initial and follow-up verification requests, and whether the plaintiff had provided the requested verification. The Court held that the defendant's verification requests sought copies of NF-5 forms signed by plaintiff's assignors, but as the plaintiff had already provided the authorizations to release information and the assignments executed by the assignors, the plaintiff had complied with the requests. The Court also held that the defendant had failed to establish the mailing of its initial and follow-up verification requests. Therefore, the order was affirmed without costs.

Reported in New York Official Reports at St. Vincent’s Hosp. & Med. Ctr. v American Tr. Ins. Co. (2010 NY Slip Op 52063(U))

St. Vincent’s Hosp. & Med. Ctr. v American Tr. Ins. Co. (2010 NY Slip Op 52063(U)) [*1]
St. Vincent’s Hosp. & Med. Ctr. v American Tr. Ins. Co.
2010 NY Slip Op 52063(U) [29 Misc 3d 139(A)]
Decided on November 26, 2010
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This opinion is uncorrected and will not be published in the printed Official Reports.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 November 26, 2010

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 9th and 10th JUDICIAL DISTRICTS


PRESENT: : IANNACCI, J.P., NICOLAI and MOLIA, JJ
2009-2147 N C.
St. Vincent’s Hospital & Medical Center as Assignee of LUIGI GANDINI and AHSAN SHABAIN, THE NEW YORK AND PRESBYTERIAN HOSPITAL as Assignee of JACQUELINE SOCARIDES, WESTCHESTER MEDICAL CENTER as Assignee of ZEV WERTBERGER and THE NYACK HOSPITAL, as Assignee of AROLDO LOPEZ, Respondents,

against

American Transit Insurance Company, Appellant.

Appeal from an order of the District Court of Nassau County, First District (Gary Franklin Knobel, J.), dated July 9, 2009. The order, insofar as appealed from as limited by the brief, granted the branches of a motion by plaintiff St. Vincent’s Hospital & Medical Center seeking summary judgment upon the first and second causes of action and denied the branches of defendant’s cross motion seeking summary judgment dismissing those causes of action.

ORDERED that the order, insofar as appealed from, is affirmed without costs.

In this action to recover assigned first-party no-fault benefits, insofar as is relevant to this appeal, plaintiff St. Vincent’s Hospital & Medical Center (SVHMC) moved for summary judgment upon the first and second causes of action, and defendant cross-moved for summary judgment dismissing those causes of action on the ground that they were premature since SVHMC had failed to fully comply with defendant’s verification requests. The District Court granted SVHMC’s motion for summary judgment upon the first and second causes of action, and denied defendant’s cross motion, finding that defendant had failed to establish the mailing of its initial and follow-up verification requests. This appeal by defendant ensued.

Contrary to the determination of the District Court, the affidavit of defendant’s claims examiner was sufficient to establish that the initial and follow-up verification requests were timely mailed in accordance with defendant’s standard office practices and procedures (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679 [2001]). However, defendant’s contention that SVHMC failed to provide requested verification lacks merit. Defendant’s verification requests sought copies of NF-5 forms signed by SVHMC’s assignors. However, the only [*2]portions of an NF-5 form which may bear the signature of an eligible injured person are the portions which authorize the release of health service or treatment information in accordance with the No-Fault Law and which either assign no-fault benefits to a provider or authorize the provider to receive payments directly from the insurer. As defendant was already in possession, prior to its verification requests, of the subject NF-5 forms, which each bore notations that the assignor’s signature was “on file,” defendant’s verification requests, in effect, sought a copy of the document(s) “on file” which had been signed by the assignors. Since SVHMC established that it had, in response to the verification requests, provided defendant with copies of the authorizations to release information and the assignments executed by the assignors, SVHMC established that it had complied with those requests. While defendant’s attorney asserted that defendant had never received the signed assignment of benefits forms, defendant’s attorney’s affirmation was without probative value as defendant’s attorney lacked personal knowledge of same (see Wolfson v Rockledge Scaffolding Corp., 67 AD3d 1001 [2009]; Fiveborough Chiropractic & Acupuncture, PLLC v American Employers’ Ins. Co. Div. of Onebeacon Am. Ins. Co., 24 Misc 3d 133[A], 2009 NY Slip Op 51395[U] [App Term, 9th & 10th Jud Dists 2009]).

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

Iannacci, J.P., Nicolai and Molia, JJ., concur.
Decision Date: November 26, 2010