October 8, 2013

Great Health Care Chiropractic, P.C. v Interboro Ins. Co. (2013 NY Slip Op 51737(U))

https://www.beynensonlaw.com/case-law/great-health-care-chiropractic-p-c-v-interboro-ins-co-2013-ny-slip-op51737u/

Court: Appellate Term, Second Department
Decided: October 8, 2013
Citation: 2013 NY Slip Op 51737(U) · 41 Misc 3d 130(A)
Posture: Other motion
Outcome: Insurer prevailed
Later treatment: Followed in 4 later decisions (see Cited by)
Issues: Discovery and procedure

Cite as

Great Health Care Chiropractic, P.C. v Interboro Ins. Co., 41 Misc 3d 130(A), 2013 NY Slip Op 51737(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2013)

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.

An insurer defending a no-fault action on medical necessity grounds is entitled to depose the provider's treating chiropractor. The insurer sought summary judgment or, alternatively, an order compelling the deposition in an action for assigned benefits. Its appeal was limited to denial of the deposition request. CPLR 3101 (a) permits disclosure of material and necessary matters regardless of the burden of proof, including facts that assist trial preparation by sharpening the issues. Because lack of medical necessity was among the insurer's defenses, the Appellate Term, Second Department, reversed the order, insofar as appealed from, and granted the branch of the insurer's motion compelling the provider to produce its treating chiropractor.

Reported in New York Official Reports at Great Health Care Chiropractic, P.C. v Interboro Ins. Co. (2013 NY Slip Op 51737(U))

[*1]

Great Health Care Chiropractic, P.C. v Interboro Ins. Co.

2013 NY Slip Op 51737(U) [41 Misc 3d 130(A)]

Decided on October 8, 2013

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This opinion is uncorrected and will not be published in the printed Official Reports.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 8, 2013

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ
2011-3066 K C.

Great Health Care Chiropractic, P.C. as Assignee of TIFFANIE ROGERS, Respondent, —
against
Interboro Insurance Company, Appellant.

Appeal from an order of the Civil Court of the City of New York, Kings County (Pamela L. Fisher, J.), entered November 1, 2011. The order, insofar as appealed from as limited by the brief, denied the branch of defendant’s motion seeking to compel plaintiff to produce its treating chiropractor for a deposition.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and the branch of defendant’s motion seeking to compel plaintiff to produce its treating chiropractor for a deposition is granted.

In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for, among other things, summary judgment dismissing the complaint or, in the alternative, to compel plaintiff to produce its treating chiropractor for a deposition. Plaintiff cross-moved for summary judgment. Defendant appeals, as limited by the brief, from so much of an order of the Civil Court as denied the branch of defendant’s motion seeking to compel plaintiff to produce its treating chiropractor for a deposition.

CPLR 3101 (a) provides for “full disclosure of all matter material and necessary in the prosecution or defense of an action, regardless of the burden of proof.” Parties to an action are entitled to reasonable discovery “of any facts bearing on the controversy which will assist preparation for trial by sharpening the issues and reducing delay and prolixity” (Allen v Crowell-Collier Publ. Co., 21 NY2d 403, 406 [1968]; see Traditional Acupuncture, P.C. v State Farm Ins. Co., 24 Misc 3d 129[A], 2009 NY Slip Op 51335[U][App Term, 2d, 11th & 13th Jud Dists 2009]). As defendant is defending this action on the ground, among others, that the services rendered lacked medical necessity, the order, insofar as appealed from, is reversed, and the branch of defendant’s motion seeking to compel plaintiff to produce its treating chiropractor for a deposition is granted.

Pesce, P.J., Aliotta and Solomon, JJ., concur. [*2]
Decision Date: October 08, 2013

Cited in this decision

Traditional Acupuncture, P.C. v State Farm Ins. Co. (2009 NY Slip Op 51335(U))The provider was entitled to depose the insurer for material and necessary discovery under CPLR 3101 (a).

Cited by

A label shows how the later decision treated this one.

Farshad D. Hannanian, M.D., P.C. v Allstate Ins. Co. (2015 NY Slip Op 51133(U)) FollowedThe treating provider's deposition was material and necessary to the insurer's medical necessity defense despite a pending summary judgment motion.
North Bronx Med. Health Care v Auto One Ins. Co. (2016 NY Slip Op 51625(U)) FollowedThe insurer was entitled to depose the treating doctor, but factual issues on medical necessity defeated summary judgment on both claims.
Huntington Regional Chiropractic, P.C. v Mercury Cas. Co. (2015 NY Slip Op 51900(U)) FollowedThe provider raised a medical-necessity issue but could not avoid a material and necessary deposition by serving written discovery responses.
Acupuncture Now, P.C. v State Farm Mut. Auto. Ins. Co. (2017 NY Slip Op 51154(U)) FollowedAn insurer may use the chiropractic acupuncture fee schedule to determine reimbursement for a licensed acupuncturist's acupuncture services.
TAM Med. Supply Corp. v Country Wide Ins. Co. (2017 NY Slip Op 50921(U))The insurer's conflicting claim-receipt dates prevented summary judgment on late accident notice, but the provider was compelled to give discovery.

Similar decisions

American Chiropractic Care, P.C. v Praetorian Ins. Co. (2014 NY Slip Op 50346(U))The provider's treating chiropractor's sworn letter raised a factual issue on medical necessity despite the insurer's peer review.
Bay Plaza Chiropractic, P.C. v Praetorian Ins. Co. (2012 NY Slip Op 52315(U))The provider's chiropractor affidavit raised a triable issue of medical necessity despite the insurer's supported peer review.
BLR Chiropractic, P.C. v American Tr. Ins. Co. (2012 NY Slip Op 50882(U))The insurer's peer review report and reviewing chiropractor's affidavit established lack of medical necessity, which the provider failed to rebut.
GC Chiropractic, P.C. v Integon Natl. Ins. Co. (2019 NY Slip Op 51800(U))The insurer was denied summary judgment because the provider had not received requested medical records needed to oppose the motion.
Bay Plaza Chiropractic, P.C. v Auto One Ins. Co. (2018 NY Slip Op 51082(U))The insurer was entitled to a provider deposition on medical necessity, but a triable factual issue precluded summary judgment.