Ava Acupuncture, P.C. v GEICO Gen. Ins. Co., 2012 NY Slip Op 50234(U)(App. Term 2d Dept. 2012)
“In this case, while the delay was lengthy, plaintiff does not deny that discovery and trial postponements intervened to delay the action and for reasons unrelated to the motion’s merits. Since the defenses address the effect of contractual terms on recovery and since plaintiff does not deny defendant’s claim that its NF-10 forms invoked a deductible, the claim of surprise or prejudice so great as to warrant the motion’s denial is not established.”
“Since plaintiff as assignee stands in the shoes of the insured, plaintiff cannot claim ignorance of the terms of the very contract under which it alleges entitlement to no-fault benefits compensation”
In another first – summary judgment was granted as to the $200 deductible portion of the insurance policy
Innovative Chiropractic, P.C. v Progressive Ins. Co., 2010 NY Slip Op 50148(U)(App. Term 2d Dept. 2010)
In another day of firsts, the Appellate Term granted the insurance carrier summary judgment motion to the extent of dismissing the portion of the complaint representing the $200 deductible portion of the disputed no-fault billing. The following was stated:
“[d]efendant did demonstrate that the applicable insurance policy contained a $200 deductible (see Insurance Department Regulations [11 NYCRR] § 65-1.6) and that defendant timely denied $200 of the claim at issue due to said deductible (see Insurance Law § 5102 [b] ). Consequently, under the circumstances presented herein, it is appropriate for this court to search the record and grant summary judgment to defendant dismissing the complaint with respect to the bills totaling $200, which bills defendant had denied based upon the $200 deductible”
As to the claim for $33.70, it looks like defense counsel forgot make mention of this particular bill in the claim representative affidavit, a scrivener’s error that all of us occasionally make.