Appeal from a judgment of the Civil Court of the City of New York, Queens County (Thomas D. Raffaele, J.), entered August 15, 2008. The judgment, entered pursuant to an order of the same court entered June 20, 2008 granting plaintiff's motion for summary judgment and denying defendant's cross motion for summary judgment dismissing the complaint, awarded plaintiff the principal sum of $4,012.91.

ORDERED that the judgment is reversed without costs, the portions of the order entered June 20, 2008 which granted plaintiff's motion for summary judgment and which denied the branches of defendant's cross motion seeking summary judgment dismissing the first, second, third, fifth, sixth, eighth and ninth causes of action are vacated, plaintiff's motion for summary judgment is denied, and the branches of defendant's cross motion seeking summary judgment dismissing the first, second, third, fifth, sixth, eighth and ninth causes of action are granted, and the matter is remitted to the Civil Court for all further proceedings on the fourth and seventh causes of action.

In this action by a provider to recover assigned first-party no-fault benefits, the Civil Court granted plaintiff's motion for summary judgment and denied defendant's cross motion for summary judgment dismissing the complaint. A judgment was subsequently entered, and this appeal by defendant ensued.

Since the affidavit of defendant's claims representative conceded receipt of the claims in question (see East Acupuncture, P.C. v Electric Ins. Co., 16 Misc 3d 128[A], 2007 NY Slip Op 51281[U] [App Term, 2d & 11th Jud Dists 2007]; Oleg Barshay, D.C., P.C. v State Farm Ins. Co., 14 Misc 3d 74 [App Term, 2d & 11th Jud Dists 2006]) and the affidavit of plaintiff's billing manager established that the documents annexed to plaintiff's motion were admissible pursuant to CPLR 4518 (see Art of Healing Medicine, P.C. v Travelers Home & Mar. Ins. Co., 55 AD3d 644 [2008]; Dan Med., P.C. v New York Cent. Mut. Fire Ins. Co., 14 Misc 3d 44 [App [*2]Term, 2d & 11th Jud Dists 2006]), plaintiff's prima facie entitlement to summary judgment was established.

The affidavit of defendant's no-fault litigation supervisor sufficiently established the timely mailing of the NF-10 denial of claim forms and verification requests since it described, in detail, based on the affiant's personal knowledge, defendant's standard office practices or procedures used to ensure that said documents were properly mailed (see Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679 [2001]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]).

In regard to plaintiff's first, second, third, fifth, sixth, eighth and ninth causes of action, defendant established that it had timely mailed its initial requests for verification (see Insurance Department Regulations [11 NYCRR] § 65-3.5 [b]), and plaintiff had failed to provide the information requested. Plaintiff also did not provide the information requested in defendant's follow-up verification requests, which were mailed on the 30th day after the initial verification requests, but prior to the expiration of the full 30-day period within which plaintiff was required to respond to defendant's initial requests for verification. As the foregoing facts are nearly identical to those in Infinity Health Prods., Ltd. v Eveready Ins. Co. (67 AD3d 862 [2d Dept 2009]), "the 30-day period within which the defendant was required to pay or deny the claim[s] did not commence to run [and] plaintiff's action is premature" (id. at 865 [citations omitted]). As a result, defendant was entitled to summary judgment dismissing these causes of action.

Defendant also established that it had timely denied the two $365.68 claims (plaintiff's fourth and seventh causes of action) on the ground that the services for which payment was sought were part of another service and, thus, were not separately reimbursable. Consequently, defendant raised a triable issue of fact with respect to the fourth and seventh causes of action (see St. Vincent's Med. Care, P.C. v Country-Wide Ins. Co., ___ Misc 3d ___, 2009 NY Slip Op 29508 [App Term, 2d, 11th & 13th Jud Dists 2009]).

Accordingly, the judgment is reversed, the portions of the order entered June 20, 2008 which granted plaintiff's motion for summary judgment and which denied the branches of defendant's cross motion seeking summary judgment dismissing the first, second, third, fifth, sixth, eighth and ninth causes of action are vacated, plaintiff's motion for summary judgment is denied, the branches of defendant's cross motion seeking summary judgment dismissing the first, second, third, fifth, sixth, eighth and ninth causes of action are granted, and the matter is remitted to the Civil Court for all further proceedings on the fourth and seventh causes of action.

Weston, J.P., Golia and Rios, JJ., concur.
Decision Date: March 10, 2010