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ISLAND LIFE CHIROPRACTIC, P.C., as Assignee of Powell, Jason, Respondent, v. ERIE INSURANCE COMPANY OF NEW YORK, Appellant.
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, defendant moved for summary judgment dismissing the complaint on the ground that it had timely denied the claim at issue based on plaintiff's failure to submit the claim to defendant within 45 days of the date the services had been rendered. The Civil Court denied defendant's motion but made, in effect, CPLR 3212 (g) findings that defendant's denial of claim form had been timely and proper, and that the sole issue for trial was defendant's defense that the claim had not been timely submitted.
Contrary to defendant's sole contention on appeal, the affidavit of plaintiff's owner was sufficient to demonstrate the existence of a triable issue of fact with respect to whether the claim had been timely submitted to defendant. Consequently, defendant did not establish, as a matter of law, that plaintiff had failed to comply with the regulation requiring submission of claims within 45 days of the services rendered (see 11 NYCRR 65-1.1).
Accordingly, the order, insofar as appealed from, is affirmed.
PESCE, P.J., ALIOTTA and ELLIOT, JJ., concur.
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Docket No: 2016-1395 K C
Decided: November 16, 2018
Court: Supreme Court, Appellate Term, New York.
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FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.
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