AFFIDAVITS IN SUPPORT OF TIMELY DENIALS

AFFIDAVITS IN SUPPORT OF TIMELY DENIALS

 

Exultant Medical Diagnostics, P.C.,  v. American Commerce Insurance Company, Slip Copy, 55 Misc.3d 136(A)Appellant.

 

Defendant appeals from an order of the District Court which denied defendant’s motion for summary judgment TO dismiss the complaint.

The Court said as follows:

Upon a review of the record, we find that defendant failed to establish that the denial of claim forms, which denied plaintiff’s claims on the ground of lack of medical necessity, had been properly and timely mailed. The affidavit of defendant’s claims adjuster did not state how defendant obtains the mailing address for the denial of claim forms, so as to ensure that the address is correct, or that the envelopes are affixed with postage (see Progressive Cas. Ins. Co. v Infinite Ortho Prods., Inc., 127 AD3d 1050 [2015]; St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Contemporary Acupuncture, P.C. v Allstate Ins. Co., 51 Misc 3d 132[A], 2016 NY Slip Op 50464[U] [App Term, 2d Dept, 9th & 10th Jud Dists 2016]). Consequently, defendant failed to establish its prima facie entitlement to summary judgment.

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