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St. Vinc. Hosp. v. Amer. Tr. Ins. Co.

Appellate Term of the Supreme Court of New York, Second Department
Nov 26, 2010
2010 N.Y. Slip Op. 52063 (N.Y. App. Term 2010)

Opinion

2009-2147 N C.

Decided November 26, 2010.

Appeal from an order of the District Court of Nassau County, First District (Gary Franklin Knobel, J.), dated July 9, 2009. The order, insofar as appealed from as limited by the brief, granted the branches of a motion by plaintiff St. Vincent's Hospital Medical Center seeking summary judgment upon the first and second causes of action and denied the branches of defendant's cross motion seeking summary judgment dismissing those causes of action.

PRESENT: IANNACCI, J.P., NICOLAI and MOLIA, JJ.


ORDERED that the order, insofar as appealed from, is affirmed without costs.

In this action to recover assigned first-party no-fault benefits, insofar as is relevant to this appeal, plaintiff St. Vincent's Hospital Medical Center (SVHMC) moved for summary judgment upon the first and second causes of action, and defendant cross-moved for summary judgment dismissing those causes of action on the ground that they were premature since SVHMC had failed to fully comply with defendant's verification requests. The District Court granted SVHMC's motion for summary judgment upon the first and second causes of action, and denied defendant's cross motion, finding that defendant had failed to establish the mailing of its initial and follow-up verification requests. This appeal by defendant ensued.

Contrary to the determination of the District Court, the affidavit of defendant's claims examiner was sufficient to establish that the initial and follow-up verification requests were timely mailed in accordance with defendant's standard office practices and procedures ( see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co. , 50 AD3d 1123 ; Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679). However, defendant's contention that SVHMC failed to provide requested verification lacks merit. Defendant's verification requests sought copies of NF-5 forms signed by SVHMC's assignors. However, the only portions of an NF-5 form which may bear the signature of an eligible injured person are the portions which authorize the release of health service or treatment information in accordance with the No-Fault Law and which either assign no-fault benefits to a provider or authorize the provider to receive payments directly from the insurer. As defendant was already in possession, prior to its verification requests, of the subject NF-5 forms, which each bore notations that the assignor's signature was "on file," defendant's verification requests, in effect, sought a copy of the document(s) "on file" which had been signed by the assignors. Since SVHMC established that it had, in response to the verification requests, provided defendant with copies of the authorizations to release information and the assignments executed by the assignors, SVHMC established that it had complied with those requests. While defendant's attorney asserted that defendant had never received the signed assignment of benefits forms, defendant's attorney's affirmation was without probative value as defendant's attorney lacked personal knowledge of same ( see Wolfson v Rockledge Scaffolding Corp. , 67 AD3d 1001 ; Fiveborough Chiropractic Acupuncture, PLLC v American Employers' Ins. Co. Div. of Onebeacon Am. Ins. Co. , 24 Misc 3d 133[A], 2009 NY Slip Op 51395[U] [App Term, 9th 10th Jud Dists 2009]).

Accordingly, the order, insofar as appealed from, is affirmed.

Iannacci, J.P., Nicolai and Molia, JJ., concur.


Summaries of

St. Vinc. Hosp. v. Amer. Tr. Ins. Co.

Appellate Term of the Supreme Court of New York, Second Department
Nov 26, 2010
2010 N.Y. Slip Op. 52063 (N.Y. App. Term 2010)
Case details for

St. Vinc. Hosp. v. Amer. Tr. Ins. Co.

Case Details

Full title:ST. VINCENT'S HOSPITAL MEDICAL CENTER as Assignee of LUIGI GANDINI and…

Court:Appellate Term of the Supreme Court of New York, Second Department

Date published: Nov 26, 2010

Citations

2010 N.Y. Slip Op. 52063 (N.Y. App. Term 2010)