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Eastern Star Acup. v. Mercury Ins. Co.

Appellate Term of the Supreme Court of New York, Second Department
Mar 8, 2010
2010 N.Y. Slip Op. 50380 (N.Y. App. Term 2010)

Opinion

2009-638 K C.

Decided March 8, 2010.

Appeal from an order of the Civil Court of the City of New York, Kings County (Noach Dear, J.), entered February 19, 2009. The order, insofar as appealed from, denied so much of defendant's motion as sought summary judgment dismissing plaintiff's complaint with respect to a claim for $55.69 (for services rendered on October 5, 2006) and a claim for $111.38 (for services rendered from November 12 to 16, 2006).

ORDERED that the order, insofar as appealed from, is reversed without costs, and so much of defendant's motion as sought summary judgment dismissing plaintiff's complaint with respect to a claim for $55.69 (for services rendered on October 5, 2006) and a claim for $111.38 (for services rendered from November 12 to 16, 2006) is granted.

PRESENT: RIOS, J.P., PESCE and STEINHARDT, JJ.


In this action by a provider to recover assigned first-party no-fault benefits, the Civil Court denied defendant's motion which, insofar as is relevant to this appeal, sought summary judgment dismissing plaintiff's complaint with respect to a claim for $55.69 (for services rendered on October 5, 2006) and a claim for $111.38 (for services rendered from November 12 to 16, 2006), finding that, with respect thereto, the "sole issue for trial is medical necessity of the bills that were denied based on a[n] independent medical examination." The instant appeal by defendant ensued.

In support of its motion for summary judgment, defendant submitted an affidavit executed by the chiropractor/acupuncturist who had performed an independent medical examination (IME), as well as an affirmed IME report, establishing, prima facie, a lack of medical necessity for the services at issue. In opposition to defendant's motion, plaintiff failed to raise a triable issue of fact. Contrary to the finding of the Civil Court, the affirmation of plaintiff's "supervising acupuncturist" did not meaningfully refer to, let alone rebut, the conclusions set forth in the IME report ( see Pan Chiropractic, P.C. v Mercury Ins. Co. , 24 Misc 3d 136[A], 2009 NY Slip Op 51495[U] [App Term, 2d, 11th 13th Jud Dists 2009]; see also Innovative Chiropractic, P.C. v Mercury Ins. Co. , 25 Misc 3d 137[A], 2009 NY Slip Op 52321[U] [App Term, 2d, 11th 13th Jud Dists 2009]). Accordingly, so much of defendant's motion as sought dismissal of the claims at issue should have been granted ( id.; see also A. Khodadadi Radiology, P.C. v NY Cent. Mut. Fire Ins. Co. , 16 Misc 3d 131[A], 2007 NY Slip Op 51342[U] [App Term, 2d 11th Jud Dists 2007]).

Rios, J.P., Pesce and Steinhardt, JJ., concur.


Summaries of

Eastern Star Acup. v. Mercury Ins. Co.

Appellate Term of the Supreme Court of New York, Second Department
Mar 8, 2010
2010 N.Y. Slip Op. 50380 (N.Y. App. Term 2010)
Case details for

Eastern Star Acup. v. Mercury Ins. Co.

Case Details

Full title:EASTERN STAR ACUPUNCTURE, P.C. a/a/o ALEJANDRO SORIANO, Respondent, v…

Court:Appellate Term of the Supreme Court of New York, Second Department

Date published: Mar 8, 2010

Citations

2010 N.Y. Slip Op. 50380 (N.Y. App. Term 2010)
907 N.Y.S.2d 436