Wednesday, October 22, 2008

The Inverted Trajectory of a Provider's Late Proof of Claim

Joseph Rockman LMT a/a/o Delilah Serrano v. Clarendon Natl. Ins. Co.

(NYC Civil Ct., Richmond Co., decided 10/17/2008)

Question: How often has a court, in any jurisdiction, invoked and followed an inverted trajectory to decide a case? Answer: Never. Before now. I checked LexisNexis. That term hasn't even appeared in a reported decision until this case.

Since I wasn't familiar with its use as a legal decision-making methodology, I looked up and Googled "inverted trajectory". Wasn't in any online dictionary or Wikipedia, so I looked for its meaning in contextual clues. Here's some of what I found:
We believe the inverted trajectories provide at least qualitative information on the subgrid convergence." -- Numerical Simulations of a Dilute Polymer Solution in Isotropic Turbulence, Dissertation Presented to the Faculty of the Graduate School of Cornell University in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy, by Shi Jin, January 2007, p. 80

Consider the point y as being the copy of point x .epsilon. S in F.sub.w at the initial configuration. Point y is fixed in F.sub.w and does not move with set S, but rather it moves relative to S. To an observer placed at the origin of F.sub.s the moving point x .epsilon. S will appear to be fixed while the fixed coordinate system F.sub.w, and the point y fixed in F.sub.w, will appear to be moving according to the inverted motion M(t). In other words, the moving observer will see the inverted trajectory ##EQU2##. -- Description the Background of the Invention Leading to U.S. Patent # 6044306, Methods and apparatus for shaping moving geometric shapes

The trajectories generated by TD group accounted for between 62% and 78% of the variance (featural-upright: R2 = .73, F(1,23) = 60.52, p < .001; featural-inverted: R2 = .62, F(1,23) = 37.53, p < .001; configural-upright: R2 = .79, F(1,23) = 87.41, p < .001), except for the configural inverted trajectory which appeared to be more variable (R2 =.23, F(1,23) = 6.82, p = .016). The control group therefore generated valid cross-sectional developmental trajectories on this task. -- The Development of Visuo-Spatial Processing in Children With Autism, Down Syndrome and Williams Syndrome, Thesis submitted for the degree of Doctor of Philosophy, by Dagmara Annaz, University of London, 2006, p. 167

It is interesting also to look at the Liapunov stability. If we invert the velocities at a certain time and also perturb randomly the positions (about 1%) we observe a substantial stability of the inverted trajectory at any energy density (Figs. (6a,6b)). This contrasts with the presence of exponentially divergent orbits in the large energy density region (positive Liapunov exponents); however this could be an effect of spacial localization oí chaotic regions, even if this behavior is far from being understood. -- Dynamics and Statistics in High Dimensional Hamiltonian Systems, Stefano Isola, Roberto Livi, Stefano Ruffo, Dipartimento di Fisica dell 'Universitá di Firenze and INFN Sezinone di Fi renze, Largo E. Fermi 2, 1-50125 Firenze Italy
Okay..., those didn't help much. It was a description of table tennis (ping pong) ball spins that finally did it for me -- a vigorous backspin apparently imparts an inverted trajectory to (and increases the distance traveled of) the ball.

Thus enlightened, I returned to study Richmond County NYC City Civil Court Judge Katherine Levine's decision in this case, which begins: "This case invokes the inverted trajectory that must be followed when an insurer raises the defense that a medical services provider has failed to timely submit its proof of claim. "

This claim involved a bill dated 4/17/07 for services rendered four and a half years earlier in October and November 2002. Clarendon asserted that the first time it learned about this claim was when plaintiff served Clarendon's law office with a summons and complaint dated August 16, 2007, which attached a chart referring to the 4/17/07 bill, but did not attach that bill. Clarendon claimed that its counsel received the actual bill when they received discovery in a related case involving the same medical provider on or about, October 10, 2007. Clarendon then issued a denial of that bill on November 7, 2007, within 30 days of its receipt of it.

Having been found to have timely denied the bill, Clarendon successfully argued on motion that plaintiff provider failed to submit its proof of claim (i.e., the bill) within 180 days (this case was decided under the "old" regulation) of the relevant dates of service. Judge Levine found that the "generic" affidavit of Dr. Rockman failed to state that he actually mailed the particular claims at issue on December 12, 2002, and his recital of his office practices did not establish, by admissible proof, that that procedure was in fact followed on that date. Moreover, "[f]atally missing from plaintiff's papers is a copy of the medical claim dated in 2002 that was purportedly mailed on December 13, 2002." Judge Levine reasoned:
Specifically, Dr. Rockman averred that it is his office's customary practice that after the envelope containing the bill is delivered to the U.S post office, a photocopy of the bill and supporting documents are then placed in the appropriate patient file and a notation is made on the file confirming the date and amount of the bill and the date the bill was mailed. He then alleged that the bills which are subject of this lawsuit were mailed on 12/13/02. However, as set forth above, plaintiff has failed to produce the bill that was purportedly mailed in December 2002 or even the notation that was made on the file concerning the mailing, and none of the documents that plaintiff did produce in support of its motion contain any reference to a mailing in December 2002. In fact, the only bill that plaintiff did produce for the dates of service in question is dated April 17, 2007, and plaintiff has offered no evidence concerning the mailing of the 2007 bill. As such, plaintiff has failed to produce any evidence that could be introduced at trial so as to defeat defendant's motion for summary judgment.
Given the aforementioned reasoning, plaintiff's cross-motion for summary judgment is denied. Along this line, it should be noted that plaintiff has failed to establish its prima facie right to judgment as it has failed to demonstrate its timely and proper submission of the claims in question See, Presbyterian Hospital, supra , 90 NY2d 274 (1997), Elmont Open MRI & Diagnostic Radiology v. Geico, 2008 NY Slip Op. 50113U, 18 Misc 3d 1117A (Dist. Ct., Nassau Co. 2008). As set forth above, plaintiff has failed to provide admissible proof of mailing of the purported bill dated December 2002. Furthermore, plaintiff has offered no evidence whatsoever to lay a foundation for the admission of the bill dated April 17, 2007. See, e.g. Complete Orthopedic Supplies v. State Farm Ins. Co., 16 Misc 3d 996 (Civil Ct. Queens Co. 2007). concerning the mailing of the bill dated April 17, 2007 that it has been able to produce.
End point of the inverted trajectory in this case: summary judgment for Clarendon, dismissing the complaint.

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