You are here: / / Insurer Did Not Demonstrate, as a Matter of Law, the Denials of Claims...
,

Insurer Did Not Demonstrate, as a Matter of Law, the Denials of Claims Were Timely and Properly Mailed—Summary Judgment In Favor of Insurer Should Not Have Been Granted

Supreme Court granted plaintiff insurer’s motion for summary judgment, declaring that the plaintiff was not obligated to pay no-fault claims submitted by the defendant because the defendant was unable to verify the validity of the claims. The Second Department reversed, finding that the plaintiff did not demonstrate, as a matter of law, that the denials had been timely and properly mailed to the defendant. The relevant proof requirements were described:

Generally, “proof that an item was properly mailed gives rise to a rebuttable presumption that the item was received by the addressee” … . ” The presumption may be created by either proof of actual mailing or proof of a standard office practice or procedure designed to ensure that items are properly addressed and mailed'” … . However, in order for the presumption to arise, office practice must be geared so as to ensure the likelihood that a denial of claim is always properly addressed and mailed … . “Denial of receipt by the insured[ ], standing alone, is insufficient to rebut the presumption” … .

Here, the plaintiffs failed to establish, prima facie, that they timely and properly mailed the denial of claim forms to the defendant. The affidavit of Joseph M. Andre … asserted that … all items were mailed through an automated system, and explained how documents were identified. However, Andre did not state, in his affidavit, how the envelopes were addressed so as to ensure that the address was correct or whether the envelope was addressed by the automated system or by an employee. He also did not state how and when the envelopes, once sealed, weighed, and affixed with postage using the automated system, were transferred to the care and custody of the United States Postal Service or some other carrier or messenger service to be delivered. Therefore, Andre’s affidavit was insufficient to establish, as a matter of law, that the denial of claim forms were timely and properly mailed to the defendant… . Progressive Cas. Ins. Co. v Infinite Ortho Prods., Inc., 2015 NY Slip Op 03340, 2nd Dept 4-22-15

 

You might also like
Burden Is On Parent to Demonstrate Exception to Statutory Relief from Making Reasonable Efforts to Reunite
PLAINTIFF WAS STRUCK BY A BOARD FROM A DISMANTLED FENCE WHICH FELL OFF A FORKLIFT; DISMANTLING THE FENCE WAS A COVERED ACTIVITY AND THE ACCIDENT WAS THE RESULT OF A COVERED ELEVATION-RELATED HAZARD; SUMMARY JUDGMENT ON THE LABOR LAW 240(1) CAUSE ACTION PROPERLY GRANTED (SECOND DEPT).
A RESTITUTION HEARING IS REQUIRED WHEN (1) THE DEFENDANT REQUESTS IT, AND (2) WHEN THE EVIDENCE OF THE AMOUNT IS INSUFFICIENT (SECOND DEPT). ​
Plaintiff Need Not Submit Any Evidence In Response to a Motion to Dismiss Alleging Failure to State a Cause of Action, Even If Defendant Does
Question of Fact Whether Structure on a Sports Field (Pole Vault Box) Was Open and Obvious Such that No Protection or Warning Was Required for Pedestrians
PLAINTIFF WAS NOT INJURED BY THE CONDITION HE WAS HIRED TO FIX IN THIS SLIP AND FALL CASE; DEFENDANT’S MOTION FOR SUMMARY JUDGMENT SHOULD NOT HAVE BEEN GRANTED (SECOND DEPT).
ALTHOUGH A CHILD WAS PRESENT IN THE HOME WHEN FATHER STRUCK HIS PREGNANT GIRLFRIEND, THERE WAS NO EVIDENCE THE CHILD SAW OR HEARD THE INCIDENT AND NO EVIDENCE THE CHILD WAS UPSET BY THE INCIDENT; THE NEGLECT AND DERIVATIVE NEGLECT (OF THE THEN UNBORN CHILD) FINDINGS REVERSED (SECOND DEPT).
AFFIDAVITS IDENTIFYING THE CAUSE OF PLAINTIFF’S FALL, SUBMITTED IN OPPOSITION TO DEFENDANT’S MOTION FOR SUMMARY JUDGMENT, SHOULD NOT HAVE BEEN REJECTED ON CREDIBILITY GROUNDS; IN THE CONTEXT OF SUMMARY JUDGMENT, THE COURT’S FUNCTION DOES NOT INCLUDE THE ASSESSMENT OF CREDIBILITY.

Categories

Sign Up for the Mailing List to Be Notified When the Site Is Updated.

  • This field is for validation purposes and should be left unchanged.

Copyright © 2026 New York Appellate Digest, Inc.
Site by CurlyHost | Privacy Policy

Under the Facts, Family Court Should Not Have Terminated Father’s Parental... Strictly Construing the Policy, Falling Through a Defective Manhole (Located...