September 19, 2016

Renelique v Allstate Ins. Co. (2016 NY Slip Op 51357(U))

Headnote

The relevant facts of the case were that the plaintiff, Pierre Jean Jacques Renelique, as an assignee of INNIS OSWALD, sought to recover assigned first-party no-fault benefits from the defendant, Allstate Insurance Company. The main issue decided by the court was whether the defendant had demonstrated its entitlement to summary judgment in dismissing the complaint. The court found that the affidavits submitted by the defendant did not sufficiently set forth a standard office practice or procedure that would ensure that the denial of claim form had been timely mailed, thus not demonstrating its entitlement to summary judgment. However, the plaintiff also failed to demonstrate its prima facie entitlement to summary judgment, as the affidavit plaintiff submitted in support of its motion failed to establish that the claim at issue had not been timely denied or that the defendant had issued a timely denial of claim. Therefore, the court modified the order by providing that the defendant's cross motion for summary judgment dismissing the complaint is denied.

Reported in New York Official Reports at Renelique v Allstate Ins. Co. (2016 NY Slip Op 51357(U))

Renelique v Allstate Ins. Co. (2016 NY Slip Op 51357(U)) [*1]

Renelique v Allstate Ins. Co.

2016 NY Slip Op 51357(U) [53 Misc 3d 129(A)]

Decided on September 19, 2016

Appellate Term, Second Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

As corrected in part through September 30, 2016; it will not be published in the printed Official Reports.

Decided on September 19, 2016

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-2563 Q C

Pierre Jean Jacques Renelique, as Assignee of INNIS OSWALD, Appellant,
against
Allstate Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Larry Love, J.), entered October 1, 2013. 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 modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied; as so modified, the order is affirmed, without 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.

Plaintiff correctly argues on appeal that the affidavits submitted by defendant did not sufficiently set forth a standard office practice or procedure that would ensure that defendant’s denial of claim form had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]). Thus, defendant did not demonstrate its entitlement to summary judgment.

However, contrary to plaintiff’s contention, plaintiff failed to demonstrate its prima facie entitlement to summary judgment, as the affidavit plaintiff submitted in support of its motion failed to establish that the claim at issue had not been timely denied (see Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 25 NY3d 498 [2015]), or that defendant had issued a timely denial of claim that was conclusory, vague or without merit as a matter of law (see Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]; Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128[A], 2011 NY Slip Op 51292[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]).

Accordingly, the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied.

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

Decision Date: September 19, 2016