Sunday, July 20, 2008

Unresponded Verfication Requests -- Provider's Action Dismissed as Premature

Beta Supply, Inc. v. Government Empls. Ins. Co.
(App. Term, 1st Dept., decided 7/16/2008)

GEICO established that it had timely requested verification from plaintiff, and that plaintiff had not responded to such requests. In REVERSING New York Civil's award of summary judgment to plaintiff and "searching the record" (what a court does before it grants relief to a non-moving party), the Appellate Term, First Department, awarded summary judgment to GEICO, dismissing the action. "Inasmuch as an insurer is not required to pay or deny a claim until it receives verification of all relevant requested information (see 11 NYCRR 65-3.8[b][3]; Nyack Hosp. v State Farm Mut. Auto. Ins. Co., 19 AD3d 569 [2005]), and it being undisputed on this record that plaintiff did not respond to defendant's verification requests, plaintiff's claim for payment was premature."

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