March 26, 2015

EMC Health Prods., Inc. v Travelers Ins. Co. (2015 NY Slip Op 50475(U))

Headnote

The relevant facts considered in this case involved a provider's attempt to recover assigned first-party no-fault benefits from an insurance company. The main issue decided was whether the provider had demonstrated its entitlement to summary judgment, and whether the insurance company had established its defense that the provider had failed to appear for properly scheduled examinations under oath. The holding of the case was that the provider had failed to demonstrate its entitlement to summary judgment, as the affidavit submitted in support of its motion failed to establish that the claim at issue had not been timely denied. However, the insurance company's cross motion for summary judgment dismissing the complaint was also denied, as it failed to establish its defense that the provider had failed to appear for properly scheduled examinations under oath. Therefore, the court modified the order to deny the insurance company's cross motion for summary judgment dismissing the complaint, but affirmed the order in all other respects.

Reported in New York Official Reports at EMC Health Prods., Inc. v Travelers Ins. Co. (2015 NY Slip Op 50475(U))

EMC Health Prods., Inc. v Travelers Ins. Co. (2015 NY Slip Op 50475(U)) [*1]

EMC Health Prods., Inc. v Travelers Ins. Co.

2015 NY Slip Op 50475(U) [47 Misc 3d 133(A)]

Decided on March 26, 2015

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This opinion is uncorrected and will not be published in the printed Official Reports.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 March 26, 2015

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-1029 K C

EMC Health Products, INC. as Assignee of OMAYRA PEREZ, Appellant, March 26, 2015
against
Travelers Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Wavny Toussaint, J.), entered March 9, 2012. 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 failed to demonstrate its prima facie entitlement to summary judgment, as the affidavit submitted in support of its motion failed to establish that the claim at issue had not been timely denied or that defendant had issued a timely denial of claim that was conclusory, vague or without merit as a matter of law (see Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 114 AD3d 33 [2013]; 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]; see also Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]). Consequently, plaintiff’s motion for summary judgment was properly denied. However, defendant’s cross motion should also have been denied, as defendant failed to establish, as a matter of law, its defense that plaintiff had failed to appear for properly scheduled examinations under oath (see e.g. 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]; Bright Med. Supply Co. v IDS Prop. & Cas. Ins. Co., 40 Misc 3d 130[A], 2013 NY Slip Op 51123[U] [App Term, 2d, 11th & 13th Jud Dists 2013]).

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: March 26, 2015