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DAC Medical PC v. MetLife Auto & Home

Issues of Fact Exist as to Insurer's Issued Requests for Verification of Medical Claims

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DECISION AND ORDER

*1  In this action for the payment of no-fault benefits, defendant moves seeking an order granting it summary judgment and dismissal of this action. Saliently, defendant avers that insofar as it properly denied plaintiff’s claims for medical services under the no-fault portion of its insured’s policy, the instant action must be dismissed. Plaintiff opposes the instant motion, asserting that defendant’s own submissions preclude summary judgment and instead warrant summary judgment in favor of plaintiff. For the foregoing reason, plaintiff cross-moves for summary judgment, seeking judgment in its favor for $1,746.71, plus interest, costs, and fees. Defendant opposes plaintiff’s cross-motion for the very same reasons it seeks summary judgment in its favor — purported proof beyond a factual dispute that it timely and properly denied plaintiff’s claims. For the reasons that follow hereinafter, defendant’s motion is granted, in part, and plaintiff’s cross-motion is denied.The instant action is for payment of no-fault insurance benefits for medical treatment. The complaint and the exhibits appended thereto, allege, in relevant part, the following: On August 19, 2014, YVETTE ORIAKNI (Oriakni) was involved in a motor vehicle accident and thereafter, sought medical treatment from plaintiff for injuries sustained. Oriakni was covered by an insurance policy issued by defendant, which pursuant to Article 51 of the Insurance Law, required payment of health related expenses and whose benefits Oriakni assigned to plaintiff. The treatments provided by plaintiff to Oriakni totaled $1,746.71, were covered by defendant’s policy, were billed to defendant, but were nevertheless not paid. Based on the foregoing, plaintiff seeks payment of the

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