November 1, 2019

Psychology YME, P.C. v Travelers Ins. (2019 NY Slip Op 51798(U))

Headnote

The court considered the fact that Psychology YME, P.C. was seeking to recover assigned first-party no-fault benefits from Travelers Insurance. The main issue decided was whether defendant's motion for summary judgment dismissing the complaint should be granted based on plaintiff's failure to provide requested verification within 120 days of the initial verification request, and whether plaintiff's cross motion for summary judgment should be granted. The holding of the case was that defendant's motion for summary judgment dismissing the complaint was granted, and plaintiff's cross motion for summary judgment was denied. The court found that defendant's proof was sufficient to demonstrate that it had timely mailed initial and follow-up verification requests, had not received the requested verification, and had timely denied the claim on that ground, and that plaintiff failed to raise a triable issue of fact in opposition.

Reported in New York Official Reports at Psychology YME, P.C. v Travelers Ins. (2019 NY Slip Op 51798(U))

Psychology YME, P.C. v Travelers Ins. (2019 NY Slip Op 51798(U)) [*1]

Psychology YME, P.C. v Travelers Ins.

2019 NY Slip Op 51798(U) [65 Misc 3d 146(A)]

Decided on November 1, 2019

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This opinion is uncorrected and will not be published in the printed Official Reports.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 1, 2019

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

PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-1073 K C

Psychology YME, P.C., as Assignee of Josie Gonzalez, Respondent,
against
Travelers Insurance, Appellant.

Law Office of Aloy O. Ibuzor (Gregory W. Broido of counsel), for appellant. Zara Javakov, P.C. (Zara Javakov of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Robin S. Garson, J.), entered March 27, 2018. The order denied defendant’s motion for summary judgment dismissing the complaint and granted plaintiff’s cross motion for summary judgment.

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

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 based on plaintiff’s failure to provide requested verification within 120 days of the initial verification request (see 11 NYCRR 65-3.5 [o]), and granting plaintiff’s cross motion for summary judgment.

Defendant’s proof was sufficient to demonstrate prima facie that it had timely mailed initial and follow-up verification requests (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]); that it had not received the requested verification; and that it had timely denied the claim on that ground. In opposition, plaintiff failed to raised a [*2]triable issue of fact.

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

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 01, 2019