Westchester Med. Ctr. v. Nationwide Mut. Ins. Co., 2010-03945

• Decision Date: 30 November 2010
• Docket Number: Index No. 14579/09,2010-03945
• Citation: 2010 NY Slip Op 08933
• Parties: Westchester Medical Center, as assignee of Sharon Bayly, appellant, v. Nationwide Mutual Insurance Company, respondent. Joseph Henig, P.C., Bellmore, N.Y., for appellant.
• Court: New York Supreme Court — Appellate Division

2010 NY Slip Op 08933

Westchester Medical Center, as assignee of Sharon Bayly, appellant,
v.
Nationwide Mutual Insurance Company, respondent.
Joseph Henig, P.C., Bellmore, N.Y., for appellant.

2010-03945
Index No. 14579/09

Supreme Court of the State of New York
Appellate Division
Second Judicial Department

Decided on November 30, 2010

Epstein, Frankini & Grammatico, Woodbury, N.Y. (Frank J. Marotta of counsel), for respondent.

PETER B. SKELOS, J.P.

JOSEPH COVELLO

RUTH C. BALKIN

SANDRA L. SGROI, JJ.

DECISION & ORDER

In an action to recover no-fault medical benefits under an insurance contract, the plaintiff appeals from an order of the Supreme Court, Nassau County (Murphy, J.), entered April 6, 2010, which denied its motion for summary judgment on the complaint.

ORDERED that the order is affirmed, with costs.

Pursuant to the statutory and regulatory framework governing the payment of no-fault automobile benefits, insurance companies are required to either pay or deny a claim for benefits within 30 days of receipt of the claim (see Insurance Law § 5106[a]; 11 NYCRR 65-3.8[c]). Here, the plaintiff failed to establish its prima facie entitlement to judgment as a matter of law on its claim for benefits since the evidence demonstrates that the defendant made a partial payment and a partial denial of the claim within 30 days after receipt thereof (see New York & Presbyt. Hosp. v Allstate Ins. Co., 31 AD3d 512; see generally Alvarez v Prospect Hosp., 68 NY2d 320).

Furthermore, under the circumstances of this case, the minor factual discrepancy contained in the defendant's denial of claim form did not invalidate the denial. In addition, the denial was not conclusory or vague, and did not otherwise involve a defense which had no merit as a matter of law (see Nyack Hosp. v State Farm Mut. Auto. Ins. Co., 11 AD3d 664, 665, quoting Amaze Med. Supply v Allstate Ins. Co., 3 Misc 3d 43, 44; cf. New York Univ. Hosp. Rusk Inst. v Hartford Acc. & Indem. Co., 32 AD3d 458, 460; Nyack Hosp. v Metropolitan Prop. & Cas. Ins. Co., 16 AD3d 564).

Since the plaintiff failed to establish its prima facie entitlement to judgment as a matter...