(DOWNLOAD) "Contemp. Med. Diag. & Treatment, P.C. v. Government Employees Insurance Co." by Appellate Term, Second Department New York Supreme Court # eBook PDF Kindle ePub Free
eBook details
- Title: Contemp. Med. Diag. & Treatment, P.C. v. Government Employees Insurance Co.
- Author : Appellate Term, Second Department New York Supreme Court
- Release Date : January 02, 2005
- Genre: Law,Books,Professional & Technical,
- Pages : * pages
- Size : 82 KB
Description
Plaintiff commenced this action to recover first-party no-fault benefits for medical services rendered to its assignors. Thereafter, it moved for summary judgment on the ground that defendant had failed to pay or deny its claims within 30 days of their receipt, in violation of Insurance Law 5106 (a) and 11 NYCRR 65.15 (g) (3) (now 11 NYCRR 65-3.8 [c]). Plaintiff further alleged that defendant had failed to extend the statutory time period by issuing a timely verification request on the prescribed forms. A review of the record indicates that plaintiff established its prima facie entitlement to summary judgment by proof that it submitted the statutory claim forms, setting forth the fact and the amount of the loss sustained, and that payment of no-fault benefits was overdue (see Insurance Law 5106 [a]; see also Mary Immaculate Hosp. v Allstate Ins. Co., 5 AD3d 742 [2004]; Amaze Med. Supply v Eagle Ins. Co., 2 Misc 3d 128[A], 2003 NY Slip Op 51701[U] [App Term, 2d & 11th Jud Dists]). The burden then shifted to defendant to show the existence of a triable issue of fact (see Alvarez v Prospect Hosp., 68 NY2d 320, 324 [1986]). Defendant opposed plaintiffs motion and cross-moved for summary judgment on the ground that it had sent timely letter requests for verification, which tolled the commencement of the 30-day period within which it was obligated to pay or deny the claim. The motion court found in favor of plaintiff, finding that defendants verification requests were not made on the prescribed forms, and therefore did not operate to toll the 30-day period.