December 22, 2017

Active Chiropractic, P.C. v Country-Wide Ins. Co. (2017 NY Slip Op 51850(U))

Headnote

The case involves a dispute between Active Chiropractic, P.C. and Country-Wide Ins. Co., regarding the recovery of assigned first-party no-fault benefits. Active Chiropractic, P.C. appealed from an order of the Civil Court that denied the branch of its motion seeking summary judgment to recover a claim for the sum of $290.64, and granted the branch of defendant's cross-motion seeking summary judgment dismissing that portion of the complaint. The main issue decided was whether defendant had timely mailed initial and follow-up requests for written verification after receiving the $290.64 claim, and whether plaintiff provided the verification requested by defendant prior to the commencement of the action. The court held that defendant established that it had timely mailed initial and follow-up requests for verification, and that plaintiff did not provide the verification requested by defendant prior to the commencement of the action, so the 30-day period within which defendant was required to pay or deny the claim did not begin to run. The appellate court affirmed the order.

Reported in New York Official Reports at Active Chiropractic, P.C. v Country-Wide Ins. Co. (2017 NY Slip Op 51850(U))

Active Chiropractic, P.C. v Country-Wide Ins. Co. (2017 NY Slip Op 51850(U)) [*1]
Active Chiropractic, P.C. v Country-Wide Ins. Co.
2017 NY Slip Op 51850(U) [58 Misc 3d 139(A)]
Decided on December 22, 2017
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This opinion is uncorrected and will not be published in the printed Official Reports.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 December 22, 2017
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, MARTIN M. SOLOMON, JJ
2015-151 Q C

Active Chiropractic, P.C., as Assignee of Chambers Jaren, Appellant,

against

Country-Wide Ins. Co., Respondent.

Petre and Zabokritsky, P.C. (Zachary Rozenberg, Esq.), for appellant. Jaffe & Koumourdas, LLP (Jean H. Kang, Esq.), for respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (William A. Viscovich, J.), entered December 1, 2014. The order, insofar as appealed from, denied the branch of plaintiff’s motion seeking summary judgment upon so much of the complaint as sought to recover upon a claim for the sum of $290.64 and granted the branch of defendant’s cross motion seeking summary judgment dismissing that portion of the complaint.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 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. Plaintiff appeals from so much of an order of the Civil Court as denied the branch of plaintiff’s motion seeking summary judgment upon so much of the complaint as sought to recover upon a claim for the sum of $290.64 and granted the branch of defendant’s cross motion seeking summary judgment dismissing that portion of the complaint.

Contrary to plaintiff’s contention, defendant established that, after receiving the $290.64 claim at issue, it had timely mailed initial and follow-up requests for written verification (see 11 NYCRR 65-3.5 [b]; 65-3.8 [l]; St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]). As defendant demonstrated that it had not received the requested verification, and plaintiff did not show that the verification had been provided to defendant prior [*2]to the commencement of the action, the 30-day period within which defendant was required to pay or deny the claim did not begin to run (see 11 NYCRR 65-3.5 [c]; 65-3.8 [a]; Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492 [2005]). Plaintiff’s remaining contentions regarding the verification requested by defendant lack merit.

Accordingly, the order, insofar as appealed from, is affirmed.

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


ENTER:
Paul Kenny
Chief Clerk
Decision Date: December 22, 2017