October 11, 2016

LMS Acupuncture, P.C. v Nationwide Ins. (2016 NY Slip Op 51542(U))

https://www.beynensonlaw.com/case-law/lms-acupuncture-p-c-v-nationwide-ins-2016-ny-slip-op51542u/

Court: Appellate Term, Second Department
Decided: October 11, 2016
Citation: 2016 NY Slip Op 51542(U) · 53 Misc 3d 142(A)
Posture: Summary judgment
Outcome: Provider prevailed
Issues: Verification requests

Cite as

LMS Acupuncture, P.C. v Nationwide Ins., 53 Misc 3d 142(A), 2016 NY Slip Op 51542(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016)

Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.

Summary

Editorial summary by Beynenson Law, not part of the court’s decision.

The insurer's motion for summary judgment dismissing the provider's claims as premature for outstanding verification was denied on appeal. The Appellate Term, Second Department, reversed the order for the reasons stated in the companion appeal, Performance Plus Med., P.C. v Nationwide Ins., decided the same day, No. 2013-2766 Q C, without supplying independent reasoning.

Reported in New York Official Reports at LMS Acupuncture, P.C. v Nationwide Ins. (2016 NY Slip Op 51542(U))

[*1]

LMS Acupuncture, P.C. v Nationwide Ins.

2016 NY Slip Op 51542(U) [53 Misc 3d 142(A)]

Decided on October 11, 2016

Appellate Term, Second Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

This opinion is uncorrected and will not be published in the printed Official Reports.

Decided on October 11, 2016

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2014-774 Q C

LMS Acupuncture, P.C., as Assignee of Jose Cajas, Appellant,
against
Nationwide Ins., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Ulysses Bernard Leverett, J.), entered March 17, 2014. The order granted defendant’s motion for summary judgment dismissing the complaint.

ORDERED that the order is reversed, with $30 costs, and defendant’s motion for summary judgment dismissing the complaint is denied.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant’s motion for summary judgment dismissing the complaint on the ground that the action was premature because plaintiff had failed to provide requested verification.

For the reasons stated in Performance Plus Med., P.C., as Assignee of Melanna Luckie v Nationwide Ins. (___ Misc 3d ____, 2016 NY Slip Op ______ [appeal No. 2013-2766 Q C], decided herewith), the order is reversed and defendant’s motion for summary judgment dismissing the complaint is denied.

Pesce, P.J., Aliotta and Solomon, JJ., concur.

Decision Date: October 11, 2016

Similar decisions

Performance Plus Med., P.C. v Nationwide Ins. (2016 NY Slip Op 51538(U))The insurer's motion for summary judgment dismissing the provider's claims as premature for outstanding verification was denied on appeal.
LMS Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2017 NY Slip Op 51137(U))The insurer established timely EUO notices and denials, the provider's nonappearance, and entitlement to dismissal without a triable factual issue.
Compas Med., P.C. v American Tr. Ins. Co. (2016 NY Slip Op 51545(U))The insurer's cross motion to dismiss the first through fifth causes of action on summary judgment for outstanding verification was denied on appeal.
Laga v Hereford Ins. Co. (2016 NY Slip Op 51543(U))The insurer's motion for summary judgment dismissing the provider's claims as premature for outstanding verification was denied on appeal.
NGM Acupuncture, P.C. v Nationwide Ins. Co. (2022 NY Slip Op 51271(U))The insurer timely denied three claims based on the provider's EUO nonappearances, with tolling preserving the deadline for one claim.