September 22, 2017

Atlantic Chiropractic, P.C. v Geico Ins. Co. (2017 NY Slip Op 51253(U))

Headnote

The Court considered the appeal from an order of the Civil Court of the City of New York, Kings County, granting summary judgment to the plaintiff, Atlantic Chiropractic, P.C., in their action to recover assigned first-party no-fault benefits from Geico Ins. Co. The main issues decided were whether defendant Geico had timely denied the claims at issue and whether there was medical necessity for the services provided. The court held that the proof submitted by Geico in opposition to the plaintiff's motion was sufficient to raise triable issues of fact regarding the timely denial of the claims and the medical necessity of the services, and therefore reversed the judgment, vacated the order, and denied the plaintiff's motion for summary judgment.

Reported in New York Official Reports at Atlantic Chiropractic, P.C. v Geico Ins. Co. (2017 NY Slip Op 51253(U))

Atlantic Chiropractic, P.C. v Geico Ins. Co. (2017 NY Slip Op 51253(U)) [*1]

Atlantic Chiropractic, P.C. v Geico Ins. Co.

2017 NY Slip Op 51253(U) [57 Misc 3d 134(A)]

Decided on September 22, 2017

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This opinion is uncorrected and will not be published in the printed Official Reports.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 September 22, 2017

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

PRESENT: : MICHAEL L, PESCE, P.J., THOMAS P. ALIOTTA, MARTIN SOLOMON, JJ
2014-2012 K C

Atlantic Chiropractic, P.C., as Assignee of Darren Cox and Joseph Johnson, Respondent,
against
Geico Ins. Co., Appellant.

The Law Office of Printz & Goldstein (Lawrence J. Chanice, Esq.), for appellant. Zara Javakov, P.C. (Zara Javakov, Esq.), for respondent (no brief filed).

Appeal from an order of the Civil Court of the City of New York, Kings County (Carol Ruth Feinman, J.), entered July 29, 2014, deemed from a judgment of the same court entered August 14, 2014 (see CPLR 5512 [a]). The judgment, entered pursuant to the July 29, 2014 order granting plaintiff’s motion for summary judgment, awarded plaintiff the principal sum of $2,700.

ORDERED that the judgment is reversed, with $30 costs, the order entered July 29, 2014 is vacated, and plaintiff’s motion for summary judgment is denied.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment, and defendant opposed the motion on the ground of lack of medical necessity. By order entered July 29, 2014, the Civil Court granted plaintiff’s motion. Defendant’s appeal from the July 29, 2014 order is deemed to be from the judgment entered pursuant thereto on August 14, 2014 (see CPLR 5512 [a]).

Defendant correctly argues that the proof it submitted in opposition to plaintiff’s motion was sufficient to raise triable issues of fact as to whether defendant had timely denied the claims at issue (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) and as to the medical necessity of the services provided.

Accordingly, the judgment is reversed, the order entered July 29, 2014 is vacated, and plaintiff’s motion for summary judgment is denied.

PESCE, P.J., ALIOTTA and SOLOMON, JJ., concur.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: September 22, 2017