Vincent Med. Servs., P.C. v Clarendon Natl. Ins. Co., 2012 NY Slip Op 50431(U)(App. Term 2d Dept. 2012).
“the affidavit of plaintiff’s billing manager stated that he had personally mailed the claim to defendant on June 15, 2006. However, we note that plaintiff’s claim form is dated June 22, 2006 and seeks to recover for services rendered to the assignor after June 15, 2006. In opposition to plaintiff’s motion and in support of the branch of its cross motion seeking summary judgment dismissing the fifth cause of action insofar as it pertained to this claim, the affidavit of defendant’s examiner contained a detailed recitation of defendant’s office practices and procedures pertaining to its receipt, filing and/or storage of claim forms, which was sufficient to show that defendant had never received the $608.40 claim form from plaintiff.”
One Response
Although this case is a good decision for the defendants, I am curious as to how the case would have turned out if there was not a discrepancy in the plaintiff’s affidavit with regard to the date that the bill was mailed. The case law on mailing holds that non-recipt by the adverse party, in an of itself, does not defeat the presumption of mailing.
Although the insurer meticulously described its procedures pertaining to receipt of bills, if the plaintiff’s affidavit did not make a blatant mistake with regard to the date that the bill was mailed out, I do think the insurer would have won.