November 16, 2018

Parisien v 21st Century Ins. Co. (2018 NY Slip Op 51652(U))

Headnote

The court considered a case in which a medical provider, acting as the assignee of a patient, was seeking to recover first-party no-fault benefits from an insurance company. The main issue in this case was whether the insurance company had properly denied the claim forms on the ground of a lack of medical necessity, and whether the denial had been timely mailed. The court ultimately held that the denial of the claim forms had been timely mailed, and therefore affirmed the lower court's decision to deny the provider's motion for summary judgment and to grant the insurance company's cross motion for summary judgment dismissing the complaint.

Reported in New York Official Reports at Parisien v 21st Century Ins. Co. (2018 NY Slip Op 51652(U))

Parisien v 21st Century Ins. Co. (2018 NY Slip Op 51652(U)) [*1]

Parisien v 21st Century Ins. Co.

2018 NY Slip Op 51652(U) [61 Misc 3d 143(A)]

Decided on November 16, 2018

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This opinion is uncorrected and will not be published in the printed Official Reports.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 16, 2018

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

PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, DAVID ELLIOT, JJ
2016-1528 K C

Jules Francois Parisien, M.D., as Assignee of Torres, Erika, Appellant,
against
21st Century Insurance Company, Respondent.

The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Law Offices of Bryan M. Rothenberg (Sharon A. Brennan of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (John J. Kelley, J.), entered May 6, 2016. The order denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint on the ground of a lack of medical necessity.

Contrary to plaintiff’s argument on appeal, defendant established that the denial of claim forms, which had denied the claims on the ground of a lack of medical necessity, had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]).

Accordingly, the order is affirmed.

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

ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 16, 2018