Compas Med., P.C. v Geico Ins. Co., 2014 NY Slip Op 51259(U)(App. Term 2d Dept, 2014)
Senor Jean Claude could not make a prima facie case on motion:
“Plaintiff’s moving papers failed to establish either that defendant had failed to pay or deny the claim within the requisite 30-day period (see Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 114 AD3d 33 [2013]), or that defendant had issued a timely denial of claim that was conclusory, vague or without merit as a matter of law (see Insurance Law § 5106 [a]; Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]). Thus, plaintiff failed to establish its entitlement to summary judgment, and its motion for summary judgment was properly denied.”
The remainder of the opinion involves Defendant not proving its defenses prima facie
One Response
Dear Jason:
Why not give credit where credit is due that Geico’s cross was overturned, and the case reinstated. Geico did not establish its primae facie case, that Compas raised triable issues of fact as to Fee Schedule, medical necessity (Appellate Term found Compas’ Affidavit Sufficient) and that the alleged non receipt of Palintiff’s bills defense failed. You missed many of the good points in the decision.