June 6, 2016

Tam Med. Supply Corp. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 50914(U))

https://www.beynensonlaw.com/case-law/tam-med-supply-corp-v-new-york-cent-mut-fire-ins-co-2016-ny-slipop-50914u/

Court: Appellate Term, Second Department
Decided: June 6, 2016
Citation: 2016 NY Slip Op 50914(U) · 52 Misc 3d 127(A)
Posture: Summary judgment
Outcome: Provider prevailed
Issues: Verification requests
Legal questions: Outstanding verification and premature actions (see the maps)

Cite as

Tam Med. Supply Corp. v New York Cent. Mut. Fire Ins. Co., 52 Misc 3d 127(A), 2016 NY Slip Op 50914(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016)

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.

The insurer's summary judgment motion asserting that outstanding verification made the provider's action premature was denied on appeal. The Appellate Term, Second Department, reversed the Civil Court's order for the reasons stated in the companion appeal, Renelique v Travelers Ins. Co., decided the same day, No. 2013-1747 Q C.

Reported in New York Official Reports at Tam Med. Supply Corp. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 50914(U))

[*1]

Tam Med. Supply Corp. v New York Cent. Mut. Fire Ins. Co.

2016 NY Slip Op 50914(U) [52 Misc 3d 127(A)]

Decided on June 6, 2016

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This opinion is uncorrected and will not be published in the printed Official Reports.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 June 6, 2016

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-1898 Q C

Tam Medical Supply Corp., as Assignee of ISHAMEL MEYERS, Appellant,
against
New York Central Mutual 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 July 26, 2013. The order granted defendant’s motion for summary judgment dismissing the complaint.

ORDERED that the order is reversed, with $30 costs, and defendant’s motion for summary judgment dismissing the complaint is denied.

In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint. By order entered July 26, 2013, the Civil Court granted defendant’s motion for summary judgment dismissing the complaint on the ground that the action was premature because plaintiff had failed to provide requested verification.

For the reasons stated in Renelique, as Assignee of Allen Haynes v Travelers Ins. Co. (___ Misc 3d ___, 2016 NY Slip Op ______ [appeal No. 2013-1747 Q C], decided herewith), the order is reversed and defendant’s motion for summary judgment is denied.

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

Decision Date: June 06, 2016

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.

Outstanding verification and premature actions

Open the full map

Did unanswered verification requests make the provider’s claim premature, or justify denying it for nonresponse?

This decision: Fact issues remain on whether the verification defense applies

Reversed the dismissal of the action as premature for unanswered verification requests and denied the insurer's summary judgment motion, adopting a companion decision's finding of a triable issue as to whether verification was outstanding.

Premature: verification outstandingNonresponse denial upheldTriable issueInsurer's showing failsProvider compliedThis decision

Of the 385 decisions on this question in the Second Department courts and the Court of Appeals, 114 (this one included) are in the same category.

Similar decisions

Tam Med. Supply Corp. v National Liab. & Fire Ins. Co. (2016 NY Slip Op 51532(U))The provider's proof of mailing requested verification raised a factual issue over whether its no-fault action was premature.
TAM Med. Supply Corp. v American Tr. Ins. Co. (2017 NY Slip Op 51025(U))The insurer's motion for summary judgment based on outstanding verification was denied on appeal.
TAM Med. Supply Corp. v 21st Century Ins. Co. (2016 NY Slip Op 51319(U))The insurer established proper mailing of verification requests and nonreceipt of the requested verification, rendering the action premature.
Tam Med. Supply Corp. v Hereford Ins. Co. (2017 NY Slip Op 51196(U))The provider's affidavit raised a factual issue over whether requested verification remained outstanding.
TAM Med. Supply Corp. v Travelers Ins. Co. (2017 NY Slip Op 51251(U))The provider's affidavit raised a triable issue as to verification receipt and defeated the insurer's prematurity motion.