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Antell v. New York Cent. Mut. Fire Ins. Co.

Appellate Term of the Supreme Court of New York, First Department
Mar 30, 2006
2006 N.Y. Slip Op. 50521 (N.Y. App. Term 2006)

Opinion

570002/05.

Decided March 30, 2006.

Plaintiff appeals from an order of the Civil Court, New York County (Donna G. Recant, J.), entered January 29, 2004, which granted defendant summary judgment dismissing the complaint.

Order (Donna G. Recant), entered January 29, 2004, affirmed, without costs.

PRESENT: DAVIS, SCHOENFELD, JJ.


In this action to recover no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground that the health care services were not provided by the plaintiff or its employees, but by an independent contractor. Civil Court granted defendant's motion. We affirm.

Insurance Department regulation 11 NYCRR 65-3.11 (a) (formerly 11 NYCRR 65.15[j][1]) provides, in relevant part, for the payment of no-fault benefits "directly to the applicant . . . or upon assignment by the applicant . . . [to] the providers of health care services. . . ." Where such services are not performed by the billing provider or its employees, but by a treating provider who is an independent contractor, the billing provider is not entitled to direct payment of assigned no-fault benefits under 11 NYCRR 65-3.11(a) ( see New York Insurance General Counsel Opinion No. 05-03-21 [2005] and Opinion No. 01-02-13 [2001]; see also A.B. Medical Services PLLC v. Liberty Mutual Ins. Co., 9 Misc 3d 36).

The unrefuted evidence establishes that the health care services for which plaintiff seeks no-fault benefits were performed by a treating physician who was an independent contractor, not plaintiff's employee. Accordingly, plaintiff is not properly considered a "provider" authorized to bill under the no-fault law.

This constitutes the decision and order of the court.


Summaries of

Antell v. New York Cent. Mut. Fire Ins. Co.

Appellate Term of the Supreme Court of New York, First Department
Mar 30, 2006
2006 N.Y. Slip Op. 50521 (N.Y. App. Term 2006)
Case details for

Antell v. New York Cent. Mut. Fire Ins. Co.

Case Details

Full title:CRAIG ANTELL, D.O., P.C., as Assignee of JEANNETTE HANLON…

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

Date published: Mar 30, 2006

Citations

2006 N.Y. Slip Op. 50521 (N.Y. App. Term 2006)
816 N.Y.S.2d 694