Viviane Etienne Med. Care v. Country-Wide Ins. Co.

Alem Cardenas received treatment for injuries he received during an automobile accident at the office of Plaintiff-medical provider. Cardenas’s automobile liability insurance policy with Defendant-insurer contained a New York State no-fault endorsement. Cardenas assigned his right to receive no-fault benefits to Plaintiff. Plaintiff later commenced this action seeking to recover no-fault insurance benefits, asserting that it timely submitted bills and claims for payment but that Defendant had not made any payments or denied the requests. Defendant asserted as an affirmative defense that payment for Plaintiff’s claims was not overdue because Plaintiff failed to submit “proper proof of the fact and amount of the loss” as required by the Insurance Law. The Appellate Division granted summary judgment for Plaintiff with respect to all the claims that were not timely denied by Defendant, concluding that Plaintiff established prima facie entitlement to summary judgment as a matter of law. The Court of Appeals affirmed, holding that the Appellate Division properly determined that Plaintiff met its prima facie summary judgment burden. View "Viviane Etienne Med. Care v. Country-Wide Ins. Co." on Justia Law