October 30, 2015

Compas Med., P.C. v Geico Ins. Co. (2015 NY Slip Op 51590(U))

Headnote

The court considered an action by a provider to recover assigned first-party no-fault benefits. The plaintiff moved for summary judgment, and the defendant cross-moved for summary judgment dismissing the complaint. The main issues decided were whether the defendant's cross-motion seeking summary judgment dismissing the third cause of action should have been denied, and whether the plaintiff was entitled to summary judgment upon its third cause of action. The holding of the case was that the branch of defendant's cross motion seeking summary judgment dismissing the third cause of action was denied and the branch of plaintiff's motion seeking summary judgment upon its third cause of action was properly denied.

Reported in New York Official Reports at Compas Med., P.C. v Geico Ins. Co. (2015 NY Slip Op 51590(U))

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

Compas Medical, P.C. as Assignee of Marie Bresaic, Appellant,
against
GEICO Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Maureen A. Healy, J.), entered March 14, 2013. The order, insofar as appealed from as limited by the brief, denied the branch of plaintiff’s motion seeking summary judgment on its third cause of action and granted the branch of defendant’s cross motion seeking summary judgment dismissing the third cause of action.

ORDERED that the order, insofar as appealed from, is modified by providing that the branch of defendant’s cross motion seeking summary judgment dismissing the third cause of action 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 moved for summary judgment and defendant cross-moved for summary judgment dismissing the complaint. By order entered March 14, 2013, insofar as appealed from as limited by the brief, the Civil Court denied the branch of plaintiff’s motion seeking summary judgment on the third cause of action and granted the branch of defendant’s cross motion seeking summary judgment dismissing the third cause of action.

Plaintiff correctly argues that the branch of defendant’s cross motion seeking summary judgment dismissing the third cause of action should have been denied. In support of a claim that plaintiff’s assignor had failed to appear for independent medical examinations (IMEs), defendant submitted affidavits and an affirmation from the medical professionals who were to perform the IMEs which stated in a conclusory manner that plaintiff’s assignor had failed to appear at the duly scheduled IMEs. These affidavits and affirmation were insufficient to establish defendant’s entitlement to summary judgment (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]; Alrof, Inc. v Safeco Natl. Ins. Co., 39 Misc 3d 130[A], 2013 NY Slip Op 50458[U] [App Term, 2d, 11th & 13th Jud Dists 2013]). Consequently, the branch of defendant’s cross motion seeking summary judgment dismissing the third cause of action should have been denied.

Plaintiff’s contention that it was entitled to summary judgment upon its third cause of action lacks merit. Plaintiff’s moving papers failed to establish either that defendant had failed to pay or deny the claim within the requisite 30-day period (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 [*2]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, 11th & 13th Jud Dists 2011]). Thus, plaintiff did not establish its prima facie entitlement to summary judgment. As a result, the branch of plaintiff’s motion seeking summary judgment upon its third cause of action was properly denied.

Accordingly, the order, insofar as appealed from, is modified by providing that the branch of defendant’s cross motion seeking summary judgment dismissing the third cause of action is denied.

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

Decision Date: October 30, 2015