MEGA AID PHARMACY INC v. CENTRAL INSURANCE COMPANY (2022)

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant's motion for summary judgment dismissing the complaint is granted.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from so much of an order of the Civil Court as denied defendant's motion which had sought summary judgment dismissing the complaint on the grounds that plaintiff's claims were submitted more than 45 days after the subject supplies had been furnished, lack of medical necessity, and that the fees sought exceeded the amounts permitted by the workers’ compensation fee schedule.

The affidavit of defendant's claims representative established that the claims at issue had been submitted more than 45 days after those supplies had been furnished (see 11 NYCRR 65-1.1) and that defendant had timely mailed (see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) its denial of claim form, which denied the claim on that ground. Furthermore, defendant's denial of claim form advised plaintiff that late notice would be excused if reasonable justification for the failure to give timely notice was provided (11 NYCRR 65-1.1). Plaintiff failed to raise a triable issue of fact in response to defendant's prima facie showing. Indeed, the claim forms annexed to a cross motion for summary judgment by plaintiff were dated more than 45 days after the supplies at issue were furnished. In light of the foregoing, defendant's motion for summary judgment dismissing the complaint should have been granted. We reach no other issue.

Accordingly, the order, insofar as appealed from, is reversed, and defendant's motion for summary judgment dismissing the complaint is granted.

ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.