Key Takeaway
Analysis of two NY appellate cases establishing prima facie requirements for no-fault insurance trials, including burden of proof for claim submission and payment denial.
V.S. Med. Servs., P.C. v Travelers Ins. Co., 2015 NY Slip Op 51760(U), 43 Misc. 3d 127(A)(App. Term 2d Dept. 2015)
“As plaintiff’s bills and proof of mailing were admitted into evidence through the testimony of its owner, who testified that the bills had not been paid, plaintiff sustained its burden of proving its prima facie case at trial.”
I am unsure why this case never made its way onto the blog here.
Bob Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co., 2016 NY Slip Op 51434(U), 53 Misc. 3d 135(A)(App. Term 2d Dept. 2016)
“As plaintiff argues, the submission of the claim forms at issue to defendant was established by the denials, annexed by both defendant and plaintiff, which admitted the receipt of those claim forms (see East Acupuncture, P.C. v Electric Ins. Co., 16 Misc 3d 128, 841 N.Y.S.2d 826, 2007 NY Slip Op 51281 ; Oleg Barshay, D.C., P.C. v State Farm Ins. Co., 14 Misc 3d 74, 831 N.Y.S.2d 821 ). Thus, in the particular circumstances of this case, including the fact that the Civil Court has made an implicit CPLR 3212 (g) finding as to the timely mailing of the denials and has limited the issues for trial, we find that the court should also have made a finding, pursuant to CPLR 3212 (g), that plaintiff had established, for all purposes in the action, the submission of the claim forms to defendant.’
Related Articles
- The Fourth Department’s discussion on what constitutes a prima facie case in no-fault law
- Carothers v. Geico: The No-Fault Business Records Showdown
- The Court’s guidance on the business records exception
- Understanding Prima Facie Cases in New York No-Fault Insurance Law
- New York No-Fault Insurance Law
