Viviane Etienne Med. Care, P.C. v. Country-Wide Ins. Co

In Viviane Etienne Med. Care, P.C. v. Country-Wide Ins. Co. (25 NY3d 498, 2015 NY Slip. Op. 04787, 14 NYS3d 283, 35 NE3d 451 [2015]), the Court of Appeals affirmed the aforementioned precedent, stating that in a no-fault summary judgment motion where benefits are overdue, the plaintiff must prove that the "statutory claim forms were mailed to and received by the insurer," citing with approval New York Hosp. Med. Ctr. of Queens v. QBE Ins. Corp. A mplifying on this standard, the Court ruled that a medical provider must "submit proof of mailing through evidence in admissible form," which proof may include "the verification of treatment form and/or an affidavit from a person or entity (1) with knowledge of the claim and how it was sent to the insurer or (2) who has relied upon the forms in the performance of their business." (Id. at 507.) In affirming the Second Department holding, the Court of Appeals also upheld the lower court's holding that the burden of proving submission is generally met by an affidavit of a billing agent or an employee averring that he or she personally mailed the claim forms to the insurer or averring that a standard office practice or procedure designed to ensure that items were properly addressed and mailed was followed. (Viviane Etienne Med. Care, P.C. v. Country-Wide Ins. Co., 114 AD3d 33, [2d Dept 2013])