April 28, 2009

Bongiorno v State Farm Ins. Co. (2009 NY Slip Op 50860(U))

Headnote

The court considered the fact that the defendant had moved for summary judgment dismissing the complaint on the ground of lack of medical necessity, and the plaintiff did not submit opposition papers. The main issue decided was whether the services rendered were medically necessary. The holding of the case was that the defendant's motion for summary judgment dismissing the complaint was granted, as they had made a prima facie showing that the plaintiff's claims were properly and timely denied based upon a lack of medical necessity, which was unrebutted due to the plaintiff not opposing the motion.

Reported in New York Official Reports at Bongiorno v State Farm Ins. Co. (2009 NY Slip Op 50860(U))

Bongiorno v State Farm Ins. Co. (2009 NY Slip Op 50860(U)) [*1]
Bongiorno v State Farm Ins. Co.
2009 NY Slip Op 50860(U) [23 Misc 3d 137(A)]
Decided on April 28, 2009
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This opinion is uncorrected and will not be published in the printed Official Reports.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 April 28, 2009

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 2nd, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : WESTON PATTERSON, J.P., GOLIA and RIOS, JJ
2008-542 RI C.
William Bongiorno, D.C. as assignee of VICTORIA ARDIZZONE, Respondent,

against

State Farm Insurance Company, Appellant.

Appeal from an order of the Civil Court of the City of New York, Richmond County (Katherine A. Levine, J.), entered February 11, 2008. The order denied defendant’s motion for summary judgment dismissing the complaint.

Order reversed without costs and defendant’s motion for summary judgment dismissing the complaint granted.

In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground of lack of medical necessity. Plaintiff did not submit opposition papers. The Civil Court denied defendant’s motion for summary judgment, finding that an issue of fact exists as to whether the services rendered were medically necessary. The instant appeal by defendant ensued.

Defendant, through the submission of the affidavit of its claims support services supervisor and the affirmed independent medical examination report, made a prima facie showing that plaintiff’s claims were properly and timely denied based upon a lack of medical necessity (see A.B. Med. Servs., PLLC v Liberty Mut. Ins. Co., 39 AD3d 779 [2007]; Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679 [2001]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins. Cos., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]). Since plaintiff did not oppose defendant’s motion, defendant’s prima facie showing was unrebutted, thereby entitling defendant to summary judgment dismissing the complaint (see A. Khodadadi Radiology, P.C. v New York Cent. Mut. Fire Ins. Co., 16 Misc 3d 131[A], 2007 NY Slip Op [*2]51342[U] [App Term, 2d & 11th Jud Dists 2007]). Accordingly, the order is reversed and defendant’s motion for summary judgment dismissing the complaint is granted.

Weston Patterson, J.P., Golia and Rios, JJ., concur.
Decision Date: April 28, 2009