GMV Med. Supplies, Inc. v MVAIC (2007 NY Slip Op 50601(U))

GMV Med. Supplies, Inc. v MVAIC

2007 NY Slip Op 50601(U) [15 Misc 3d 128(A)]

Decided on March 26, 2007

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This opinion is uncorrected and will not be published in the printed Official Reports.

GMV Medical Supplies, Inc. as Assignee of Samuel Mendez, Respondent,

against

MVAIC, Appellant.

Appeal by defendant from an order of the District Court of Suffolk County, Third District (C. Steven Hackeling, J.), dated August 2, 2005. The order denied defendant's motion for summary judgment dismissing the complaint.

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 plaintiff failed to establish that the assignor was a "qualified person" and, therefore, plaintiff was not entitled to recover no-fault benefits as assignee. The court below denied defendant's motion and the instant appeal by defendant ensued.

Contrary to defendant's contention, the 30-day requirement within which to pay or deny a claim (11 NYCRR 65-3.8 [c]), which applies to defendant Motor Vehicle Accident Indemnification Corporation (sued herein as MVAIC) as well as to other insurers (Insurance Law § 5221 [b] [3]), begins to run upon defendant's receipt of the claim form, and does not depend upon whether the eligible injured person has been deemed to be a "qualified person" (Insurance Law § 5202 [b]) by defendant (New York
Hosp. Med. Ctr. of Queens v Motor Veh. Acc. Indem. Corp., 12 AD3d 429, 430 [2004]). Were the rule otherwise, defendant would be able to "obviate the 30-day time requirement [which] would frustrate the purpose and objective of the No-Fault Law" (id. at 430) to ensure prompt [*2]payment of first party no-fault benefits without regard to fault, and "to provide a tightly-timed process of claim disputation and payment" (id., quoting Presbyterian Hosp. in City of N.Y. v Maryland Cas. Co., 90 NY2d 274, 281 [1997]). Since defendant did not establish that it timely requested verification and that it did not receive the verification requested, defendant failed to demonstrate its entitlement to summary judgment (see Zuckerman v City of New York, 49 NY2d 557 [1980]; cf.
Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492 [2005]). Accordingly, the court below properly denied defendant's motion for summary judgment dismissing the complaint.