Eagle Surgical Supply, Inc. v Allstate Ins. Co., 2014 NY Slip Op 50343(U)(App. Term 2d Dept. 2014)
Method (1): The biller and the NF-10 –
Plaintiff sufficiently established that the NF-10 denial of claim form that it was trying to introduce into evidence was the denial of claim form that it had received from defendant, which referenced the claim form at issue in this action. Contrary to the ruling of the Civil Court, plaintiff should have been allowed to use that denial to demonstrate that the claim form in question had been submitted to defendant (see East Acupuncture, P.C. v Electric Ins. Co., 16 Misc 3d 128[A], 2007 NY Slip Op 51281[U] [App Term, 2d & 11th Jud Dists 2007]; Oleg Barshay, D.C., P.C. v State Farm Ins. Co., 14 Misc 3d 74 [App Term, 2d & 11th Jud Dists 2006]). In such a case, a plaintiff is not trying to use the denial as the plaintiff’s own business record pursuant to CPLR 4518 (a); instead, in this context, the denial is being used as an admission by the defendant that the claim form had been received.
Method 2 would be Interrogatories and Notices to Admit
Method 3 would be the claims representative admitting to receipt of the bills through the denial and lack of payment of the bill.
It is 2003 all over again.
10 Responses
A year ago a plaintiff had to climb a mountain to establish prima facie in the 2nd Department. Now ….
I don’t know. The Captain is a superhero — not a no fault lawyer. But I believe there are laws on the books that go as far as criminalizing the above insurance company behavior.
What I am saying is that if an insurance received a bill from a provider under the law the insurance company would have to admit it. Admit it with zeal. There is a statutory duty in no fault and beyond to not cheat or delay your premium payers.
Of course you can say medically unnecessary etc. But why would you have to make your client insured premium payer prove something that you damn well know is true.
I think we need to go back even further … to when there was no no fault.
Jason please don’t make me do the research.
I saw what my little friend Wang did.
Ahhh Haaa … this is ahh Wang Chung.
So Captwan I awm your “wittle friend.” Why am I wittle. Becwause I am frwom China.
Look at a famwous basketbwall player Whuge Wang. He wery bwig.
I wite the waw you idiot. That wery bwig.
Wang Chung — you cwazy. Everybody have fun tonight, The 2nd Dept Wang Chung tonight
That is enough Wang. If you are looking to get insulted I will oblige. I don’t care if you speak with an accent but you can’t “wite the waw” with an accent.
Go join the rest of your profession and get remedial English classes.
P.S. Bruce Lee was small but look at his impact. And he didn’t “wite the waw.”
Sorry Jason I started this.
Aaaaah … This is ah Wang Chung. I see you have yourwe fwriends making fun of the wittle man fwrom China.
Well Mr. Captain Amerwica what do you think of Putin mwaking a fool out of you.
See what I mean? I love you but get a life.
Dear Wang:
You forget that the Captain was cryogenically frozen for over 60 years. I know of no cold war. I fought Nazis. The Russians were our friends.
So I do not care about what Putin is doing.
I am to busy still fighting Nazis. When I awoke I found that the Nazis were now in America. Corporations and their politician puppets with their constant state of war; scapegoats; slogans; symbols and disdain for intellectuals.
So I did not have to travel to wade right into the battle.
Sincerely,
Captain America
Captain American was also killed by Sharon Carter his old girlfriend in the story arc beginning in Captain American #25 only to be resurrected again. The Red Skull is your true enemy – American is NOT – and I have reason to believe that Jason Tenenbaum is THE RED SKULL.