June 17, 2022

Lefferts Gardens Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co. (2022 NY Slip Op 50599(U))

Headnote

The relevant facts in this case include that Lefferts Gardens Chiropractic, P.C. was seeking to recover assigned first-party no-fault benefits from New York Central Mutual Fire Insurance Company. The defendant appealed from an order of the Civil Court that denied their motion for summary judgement dismissing the complaint on the ground that the action was premature, as the plaintiff failed to respond to requests for additional verification. The main issue was whether the defendant's proof was sufficient to demonstrate that verification requests had been timely sent to the plaintiff, and whether the follow-up verification requests issued by the defendant were proper. The holding of the case was that the Court reversed the order and granted the defendant's motion for summary judgement, dismissing the complaint, as they found that the proof submitted by the defendant was sufficient to demonstrate that verification requests had been timely sent to the plaintiff and that they had not received a response to the verification letters.

Reported in New York Official Reports at Lefferts Gardens Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co. (2022 NY Slip Op 50599(U))

Lefferts Gardens Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co. (2022 NY Slip Op 50599(U)) [*1]

Lefferts Gardens Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co.

2022 NY Slip Op 50599(U) [75 Misc 3d 140(A)]

Decided on June 17, 2022

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This opinion is uncorrected and will not be published in the printed Official Reports.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 17, 2022

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

PRESENT: : THOMAS P. ALIOTTA, P.J., MICHELLE WESTON, WAVNY TOUSSAINT, JJ
2019-1303 K C

Lefferts Gardens Chiropractic, P.C., as Assignee of Anna Gurley, Respondent,
against
New York Central Mutual Fire Insurance Company, Appellant.

Nightingale Law, P.C. (Michael S. Nightingale of counsel), for appellant. Zara Javakov, P.C. (Zara Javakov and Victoria Tarasova of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered May 28, 2019. The order denied 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 granted.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court denying defendant’s motion which had sought summary judgment dismissing the complaint on the ground that the action is premature, as plaintiff failed to respond to defendant’s timely requests for additional verification.

The proof submitted by defendant was sufficient to demonstrate that verification requests had been timely sent to plaintiff (see 11 NYCRR 65-3.8 [l]; St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) and that defendant had not received a response to the verification letters from plaintiff. Contrary to plaintiff’s contentions, the follow-up verification requests issued by defendant were proper (see 11 NYCRR 65-3.6 [b]). In any event, “[a]ny confusion on the part of [] plaintiff as to what was being sought should have been addressed by further communication, not inaction” (Westchester County Med. Ctr. v NY Cent. Mut. Fire Ins. Co., 262 AD2d 553, 555 [1999]; see Healthy Way Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co., 58 Misc 3d 137[A], 2017 NY Slip Op 51828[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017]).

Accordingly, the order is reversed and defendant’s motion for summary judgment dismissing the complaint is granted.

ALIOTTA, P.J., WESTON and TOUSSAINT, JJ., concur.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 17, 2022