New Horizon Surgical Ctr., LLC v. Travelers Ins. Co.

New Horizon Surgical Center, LLC, as Assignee of Charity Calhoun, Respondent, against Travelers Insurance Company, Appellant. Law Office of Aloy O. Ibuzor (Alla Pecker of counsel), for appellant. Strauss Terry Law Group, for respondent (no brief filed). Appeal from an order of the Civil Court of the City of New York, Richmond County (Lizette Colon, J.), entered June 29, 2017. The order denied defendant's motion for summary judgment dismissing the complaint. ORDERED that the order is reversed, with $30 costs, and defendant's motion for summary judgment dismissing the complaint is granted. In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court denying defendant's motion which had sought summary judgment dismissing the complaint on the ground that plaintiff had failed to provide requested verification. The proof defendant submitted was sufficient to give rise to a presumption that the initial and follow-up verification requests had been properly mailed (see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]), and to demonstrate that defendant had not received the requested verification. Contrary to plaintiff's contention, defendant was not required to pay or deny plaintiff's claims upon receipt of a "partial response" to defendant's verification requests (see 11 NYCRR [*2]65-3.8 [a] [1]; [b] [3]; New York & Presbyt. Hosp. v Progressive Cas. Ins. Co., 5 AD3d 568, 570 [2004] ["A claim need not be paid or denied until all demanded verification is provided"]). Accordingly, the order is reversed and defendant's motion for summary judgment dismissing the complaint is granted. PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur. ENTER: Paul Kenny Chief Clerk Decision Date: October 18, 2019