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MAIMONIDES v. FIRST UNITED

2012-03138

116 A.D.3d 207 (2014)

981 N.Y.S.2d 739

2014 NY Slip Op 1441

MAIMONIDES MEDICAL CENTER, Respondent, v. FIRST UNITED AMERICAN LIFE INSURANCE COMPANY, Appellant.

Appellate Division of the Supreme Court of New York, Second Department.

Decided March 5, 2014.

Attorney(s) appearing for the Case

Southerland Asbill & Brennan LLP, New York City ( Ellen M. Dunn and Peter Ligh of counsel), for appellant.

Proskauer Rose LLP, New York City ( Edward S. Kornreich , Roger A. Cohen and Yafang Deng of counsel), for respondent.

Greenberg Traurig, LLP, Albany ( Harold N. Iselin and Cynthia Neidl of counsel), for New York Health Plan Association, Inc., amicus curiae.

RIVERA, J.P., DILLON and DICKERSON, JJ., concur.

OPINION OF THE COURT

AUSTIN, J.

Insurance Law § 3224-a, known as the Prompt Pay Law, imposes standards upon insurers for the "prompt, fair and equitable" payment of claims for health care services. The statute sets forth time frames within which an insurer must either pay a claim, notify the claimant of the reason for denying a claim, or request additional information. An insurer that fails to comply with the provisions of the Prompt Pay Law is obligated...

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