Atlantic Radiology Imaging, P.C. v Travelers Prop. Cas. Co. of Am., 2018 NY Slip Op 50053(U)(App. Term 1st Dept. 2018)
“It being undisputed on this record that plaintiff failed to fully respond to the defendant-insurer’s verification requests, defendant established its prima facie entitlement to summary judgment dismissing the underlying first-party no-fault claims as premature (see St. Vincent Med. Care, P.C. v. Country Wide Ins. Co., 80 AD3d 599, 600 [2011]). Even accepting plaintiff’s speculative assertion that defendant’s followup verification request was issued two days beyond the 10-day period prescribed by the regulation (see 11 NYCRR 65-3.6), this does not, under the circumstances here presented, deprive defendant of the benefit of the tolling of the 30-day period during which an insurer must pay or deny the claim (see Infinity Health Prods., Ltd. v Eveready Ins. Co., 67 AD3d 862 [2009]; Triangle R Inc. v Praetorian Ins. Co., 30 Misc 3d 129[A], 2010 NY Slip Op 52294[U] [App Term, 1st Dept 2010]).”
Two points to be fleshed out here. First, all verification was not received. Problem. Second, the follow-up can be late without consequence. I sense divergence from the Second Department (AT).
Initially, a late follow-up according to the AT second department eliminated the toll. The AT First says otherwise.
Second, how do you harmonize the line of AT 2nd cases saying that the affidavit of compliance with verification is sufficient whereas this case which seems to look for record support regarding received verification?
One Response
THe 1st dept. is clueless. The regs sate 10 days to followup. What dont they understand. All the case law says that if not served within 10 days the denial cant be sustained and the 30 day does not toll. Makes no sense. SMDH