Howard M. Rombom, Ph D, P. C. v. Interboro Mutual Indemnity Insurance

Appellate Terms of the Supreme Court of New York

Howard M. Rombom, Ph D, P. C. v. Interboro Mutual Indemnity Insurance

186 Misc. 2d 847, 721 N.Y.S.2d 474, 2000 N.Y. Misc. LEXIS 572

Appellate Terms of the Supreme Court of New York·Decided December 6, 2000·Published·Cited by 1 cases

Opinion

OPINION OF THE COURT

Memorandum.

Order unanimously affirmed without costs and matter [848]*848remanded to the court below for further proceedings in accordance with the decision herein.

Defendant’s failure to deny plaintiffs claim for no-fault benefits within 30 days of receipt of proof of claim and amount of loss sustained (see, Insurance Law § 5106; 11 NYCRR 65.15 [g] [3]) precludes defendant from asserting the affirmative defense of denial of benefits on the ground that the tests administered were “not medically reasonable and/or necessary” (see, Presbyterian Hosp. v Maryland Cas. Co., 90 NY2d 274). Since plaintiff submitted proper proof of claim, summary judgment was properly granted in his favor. The matter is accordingly remanded to the court below for a calculation of the statutory interest on the claim and attorney’s fees (see, Insurance Law § 5106 [a]; 11 NYCRR 65.15 [h] [1]; 67.17 [b] [6] [iii], [v]; see also, St. Clare’s Hosp. v Allstate Ins. Co., 215 AD2d 641; Sehgal v Royal Ins. Co., NYLJ, Apr. 15, 1999, at 31, col 4 [App Term, 9th & 10th Jud Dists]).

DiPaola, P. J., Palella and Doyle, JJ., concur.

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OPINION OF THE COURT

Memorandum.

Order unanimously affirmed without costs and matter [848]*848remanded to the court below for further proceedings in accordance with the decision herein.

Defendant’s failure to deny plaintiffs claim for no-fault benefits within 30 days of receipt of proof of claim and amount of loss sustained (see, Insurance Law § 5106; 11 NYCRR 65.15 [g] [3]) precludes defendant from asserting the affirmative defense of denial of benefits on the ground that the tests administered were “not medically reasonable and/or necessary” (see, Presbyterian Hosp. v Maryland Cas. Co., 90 NY2d 274). Since plaintiff submitted proper proof of claim, summary judgment was properly granted in his favor. The matter is accordingly remanded to the court below for a calculation of the statutory interest on the claim and attorney’s fees (see, Insurance Law § 5106 [a]; 11 NYCRR 65.15 [h] [1]; 67.17 [b] [6] [iii], [v]; see also, St. Clare’s Hosp. v Allstate Ins. Co., 215 AD2d 641; Sehgal v Royal Ins. Co., NYLJ, Apr. 15, 1999, at 31, col 4 [App Term, 9th & 10th Jud Dists]).

DiPaola, P. J., Palella and Doyle, JJ., concur.

Howard M. Rombom, Ph D, P. C. v. Interboro Mutual Indemnity Insurance, 186 Misc. 2d 847, 721 N.Y.S.2d 474, 2000 N.Y. Misc. LEXIS 572 (N.Y. Ct. App. 2000).

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186 Misc. 2d 847 (Howard M. Rombom, Ph D, P. C. v. Interboro Mutual Indemnity Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Opinion

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