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Points of Health Acupun. v. Geico Ins.

Appellate Term of the Supreme Court of New York, Second Department
Dec 1, 2009
2009 N.Y. Slip Op. 52445 (N.Y. App. Term 2009)

Opinion

2008-1807 K C.

Decided December 1, 2009.

Appeal from an order of the Civil Court of the City of New York, Kings County (Dawn Marie Jimenez, J.), entered July 11, 2008. The order granted plaintiff's motion for summary judgment.

ORDERED that the order is affirmed without costs.

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


In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court granting plaintiff's motion for summary judgment.

Contrary to defendant's contention, the affidavit submitted by plaintiff's supervisor of medical billing in support of the motion was sufficient to establish that the documents annexed to plaintiff's moving papers were admissible pursuant to CPLR 4518 ( see Art of Healing Medicine, P.C. v Travelers Home Mar. Ins. Co. , 55 AD3d 644 ; Dan Med., P.C. v New York Cent. Mut. Fire Ins. Co. , 14 Misc 3d 44 [App Term, 2d 11th Jud Dists 2006]). In addition, as the affidavit executed by defendant's claim representative stated that she began working for defendant after the denial of claim forms at issue were allegedly mailed by defendant, and defendant did not otherwise establish actual mailing of the denial of claim forms or its standard office practice and procedure for the mailing of denial of claim forms during the pertinent time period, defendant failed to establish that its denial of claim forms were timely mailed ( see Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins. , 17 Misc 3d 16 [App Term, 2d 11th Jud Dists 2007]). Accordingly, as defendant was precluded from interposing its defense of lack of medical necessity ( see Presbyterian Hosp. in City of NY v Maryland Cas. Co., 90 NY2d 274, 282), the Civil Court properly granted plaintiff's motion for summary judgment.

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


Summaries of

Points of Health Acupun. v. Geico Ins.

Appellate Term of the Supreme Court of New York, Second Department
Dec 1, 2009
2009 N.Y. Slip Op. 52445 (N.Y. App. Term 2009)
Case details for

Points of Health Acupun. v. Geico Ins.

Case Details

Full title:POINTS OF HEALTH ACUPUNCTURE, P.C. a/a/o ELIZABETH CARABALLO, Respondent…

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

Date published: Dec 1, 2009

Citations

2009 N.Y. Slip Op. 52445 (N.Y. App. Term 2009)
906 N.Y.S.2d 775