Key Takeaway
Court confirms General Construction Law timing rules apply to no-fault denials, emphasizing proper mailing procedures and calculation of deadlines in insurance disputes.
No-fault insurance disputes often hinge on precise timing requirements and proper procedural compliance. When insurance companies deny claims, they must follow specific rules about how and when those denials are communicated. The General Construction Law provides crucial guidance on calculating deadlines and determining when notices are considered properly delivered.
In healthcare provider cases, establishing proper mailing procedures can make or break a case. Insurance companies must demonstrate not only that they sent required notices, but that they followed established protocols for doing so. This becomes particularly important when disputes arise about whether denials were timely or contained the necessary legal language.
The interplay between mailing procedures and deadline calculations frequently determines case outcomes. Courts scrutinize both the substance of denials and the procedural mechanics of their delivery, applying General Construction Law principles to resolve timing disputes.
Jason Tenenbaum’s Analysis:
Tam Med. Supply Corp. v Citiwide Auto Leasing, 2016 NY Slip Op 50748(U)(App. Term 2d Dept. 2016)
“Contrary to plaintiff’s arguments on appeal, defendant established a proper practice and procedure of mailing of its denials (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ), and that the denials containing the requisite language had been timely mailed (see General Construction Law §§ 25, 25-a; VS Care Acupuncture v State Farm Mut. Auto. Ins. Co., 46 Misc 3d 141, 2015 NY Slip Op 50164 ; see also General Construction Law § 20 he day from which any specified period of time is reckoned shall be excluded in making the reckoning”]). Plaintiff’s remaining contention as to defendant’s cross motion lacks merit. Thus, we leave the granting of defendant’s cross motion undisturbed.”
Key Takeaway
This decision reinforces that insurance companies can successfully defend denial challenges by demonstrating proper mailing procedures and compliance with General Construction Law timing requirements. The court’s analysis shows how procedural compliance, combined with proper application of deadline calculation rules, can dispose of provider challenges to claim denials. Similar principles apply in cases involving examination under oath procedures where personal knowledge requirements become crucial to establishing proper notice.
