Health Needles Acupuncture, P.C. v Allstate Ins. Co.

[*1] Health Needles Acupuncture, P.C. v Allstate Ins. Co. 2015 NY Slip Op 50776(U) Decided on May 18, 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 This opinion is uncorrected and will not be published in the printed Official Reports.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 May 18, 2015
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-2642 K C

Health Needles Acupuncture, P.C. as Assignee of KIM LUMHOO, Appellant,

against

Allstate Insurance Company, Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Harriet L. Thompson, J.), entered September 6, 2012. The order denied plaintiff's motion for summary judgment.

ORDERED that the order is affirmed, with $25 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.

In support of its motion, plaintiff submitted an affidavit executed by plaintiff's owner which demonstrated, prima facie, that the claim forms at issue had been mailed to and received by defendant, and that defendant had failed to pay or deny the claim within the prescribed 30-day period (see Insurance Law § 5106 [a]; Viviane Etienne Med. Care, P.C. v Country—Wide Ins. Co., 114 AD3d 33, 35 [2013]). Consequently, plaintiff established its prima facie entitlement to judgment as a matter of law based on the untimeliness of the denials. However, the affidavits submitted by defendant in opposition to plaintiff's motion sufficiently described defendant's standard mailing practices and procedures to establish the timely mailing of the denial of claim forms (see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]). As defendant raised a triable issue of fact (see NYU-Hospital for Joint Diseases v Esurance Ins. Co., 84 AD3d 1190 [2011]), plaintiff's motion for summary judgment was properly denied.

Accordingly, the order is affirmed.

Pesce, P.J., Aliotta and Solomon, JJ., concur.

Decision Date: May 18, 2015