Sunday, June 21, 2009

No Denial Provided

- Within thirty (30) days after a claimant submits “proof of the fact and amount of loss sustained”, an insurer must pay or deny a claim for insurance coverage of medical expenses arising from a motor vehicle accident. N.Y. Ins. Law §5106(a); Central Gen. Hosp. v. Chubb Group of Ins. Cos., 90 N.Y.2d 195, 200 (1997); Mount Sinai Hosp. v. Triboro Coach, 263 A.D.2d 11, 16 (2nd Dept. 1999). See 11 N.Y.C.R.R. §65.15(g)(3); Presbyterian Hosp. in City of N.Y. v. Maryland Cas. Co., 90 N.Y.2d 274, 278 (1997); New York Hosp. Med. Ctr. of Queens v. Country-Wide Ins. Co., 295 A.D.2d 583, 584 (2nd Dept. 2002).

- If a No-Fault claim is not paid or denied within thirty days of its receipt by the insurer, it is “overdue”, commencing the accrual of interest and attorneys fees. See N.Y. Ins. Law §5106[a] (McKinney 2000); 11NYCRR §65.15(g)(3); Presbyterian Hospital v. Maryland Cas. Co., 90 N.Y.2d 274, 660 N.Y.S.2d 536 (1997).

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