Appellate Term, Second Department
Jul 26, 2024
2024 NY Slip Op 51164(U)
Insurer prevailed
MVAIC established that the assignor was not a qualified person because the assignor owned the vehicle operated at the time of the accident. The Appellate Term, Second Department, reversed the order, insofar as appealed from, and granted MVAIC summary judgment dismissing the provider's assigned no-fault complaint. Applying Vehicle and Traffic Law § 128 and Insurance Law §§ 5102 (e) and 5202 (b), the court found ownership established prima facie. The assignor therefore was ineligible to be deemed a covered person entitled to MVAIC benefits under Insurance Law § 5221 (b) (2). The provider failed to raise a triable factual issue.
Trial court, Second Department
Jul 29, 2024
2024 NY Slip Op 50979(U)
Provider prevailed
MVAIC's summary judgment motion failed because the record showed partial compliance and evidence of a reasonable excuse for delay. The Civil Court, Kings County, denied dismissal of the provider's assigned no-fault action and directed a trial. The court read Insurance Law § 5208 (b) and (a) (2) (B) as requiring reasonable compliance, construed liberally to serve MVAIC's public mission. MVAIC bore the burden of proving by admissible evidence that the assignor was not qualified. Its evidence acknowledged partial compliance, while the provider supplied evidence of a reasonable excuse for the untimely amended police report and other requested documents. The factual circumstances required trial under that standard.
Trial court, Second Department
Jul 15, 2024
2024 NY Slip Op 24209
Insurer prevailed
The insurer's post-EUO verification request tolled its time to pay or deny despite being sent one business day late. The Civil Court, Richmond County, granted the insurer's summary judgment motion and dismissed the provider's complaint for failure to supply verification within 120 days. Under 11 NYCRR 65-3.5 (b) and 65-3.8 (l), requesting verification 16 business days after receiving the bill reduced the payment or denial period by one day, leaving eight days when the request tolled that period. The insurer timely followed up under 11 NYCRR 65-3.6 (b) and properly denied the claim after 120 days under 11 NYCRR 65-3.5 (o). The court distinguished Burke because the initial post-EUO request here preceded expiration of the adjusted payment or denial period.
