USING THE DENIAL TO ESTABLISH THE PRIMA FACIA CASE

USING THE DENIAL TO ESTABLISH THE PRIMA FACIA CASE

Bob Acupuncture, P.C., v. New York Central Mutual Fire Insurance Company, 2016 N.Y. Slip Op. 51434(U)

plaintiff established the submission of the claim forms to defendant by virtue of the defendant, insurer’s denial.  The Court said as follows:
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[A], 2007 NY Slip Op 51281[U] [App Term, 2d Dept, 2d & 11th Jud Dists 2007]; Oleg Barshay, D.C., P.C. v State Farm Ins. Co., 14 Misc 3d 74 [App Term, 2d Dept, 2d & 11th Jud Dists 2006]). 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 (see New York Diagnostic Med. Care, P.C. v GEICO Gen. Ins. Co., 42 Misc 3d 1 *2 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2013]).

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