June 2, 2009

Careplus Med. Supply, Inc. v Utica Mut. Ins. Co. (2009 NY Slip Op 51132(U))

https://www.beynensonlaw.com/case-law/careplus-med-supply-inc-v-utica-mut-ins-co-2009-ny-slip-op51132u/

Court: Appellate Term, Second Department
Decided: June 2, 2009
Citation: 2009 NY Slip Op 51132(U) · 23 Misc 3d 145(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Provider's prima facie case
Legal questions: Claimant's prima facie case on motions (see the maps)

Cite as

Careplus Med. Supply, Inc. v Utica Mut. Ins. Co., 23 Misc 3d 145(A), 2009 NY Slip Op 51132(U) (App Term, 2d Dept, 9th & 10th Jud Dists 2009)

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 provider failed to establish its prima facie case because its affidavit did not establish admissibility of the supporting documents. In this action for assigned no-fault benefits, the insurer opposed summary judgment by challenging the affidavit of the provider's president and medical biller. That affidavit failed to establish that the attached documents were admissible under CPLR 4518. The Appellate Term, Second Department, affirmed the order denying the provider's motion for summary judgment and reached no other issue.

Reported in New York Official Reports at Careplus Med. Supply, Inc. v Utica Mut. Ins. Co. (2009 NY Slip Op 51132(U))

[*1]

Careplus Med. Supply, Inc. v Utica Mut. Ins. Co.

2009 NY Slip Op 51132(U) [23 Misc 3d 145(A)]

Decided on June 2, 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This opinion is uncorrected and will not be published in the printed Official Reports.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 June 2, 2009

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 9th and 10th JUDICIAL DISTRICTS

PRESENT: : RUDOLPH, P.J., TANENBAUM and MOLIA, JJ
2008-1445 N C.

Careplus Medical Supply, Inc. a/a/o PAUL ANDERSON and ALICIA PRINCE, Appellant,
against
Utica Mutual Insurance Company, Respondent.

Appeal from an order of the District Court of Nassau County, Third District (Bonnie P. Chaikin, J.), entered June 18, 2008. The order denied plaintiff’s motion for summary judgment.

Order affirmed without costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment. Defendant opposed the motion, arguing, inter
alia, that the affidavit by plaintiff’s president and medical biller failed to make a prima facie showing of plaintiff’s entitlement to judgment as a matter of law. The District Court denied plaintiff’s motion, holding, inter alia, that plaintiff failed to establish its prima facie case. This appeal by plaintiff ensued.

Plaintiff failed to make a prima facie showing of its entitlement to summary judgment since the affidavit submitted by plaintiff’s president and medical biller failed to establish that the documents annexed to plaintiff’s moving papers were admissible pursuant to CPLR 4518 (see Alvarez v Prospect Hosp., 68 NY2d 320 [1986]; Art of Healing Medicine, P.C. v Travelers Home & Mar. Ins. Co., 55 AD3d 644 [2008]; Fortune Med., P.C. v Allstate Ins. Co., 14 Misc 3d 136[A], 2007 NY Slip Op 50243[U] [App Term, 9th & 10th Jud Dists 2007]). Consequently, plaintiff’s motion for summary judgment was properly denied. We reach no other issue.

Rudolph, P.J., Tanenbaum and Molia, JJ., concur.
Decision Date: June 02, 2009

Legal questions

A question of no-fault law this decision rules on, from our Legal Questions pages. Bars count the decisions on the question by year and court, coloured by category; circles are this decision and the decisions on the question it cites or that cite it. Point at a bar or circle for details. The categories and summaries are Beynenson Law’s classification, made by a language model and checked by a second reading.

Claimant's prima facie case on motions

Open the full map

On summary judgment or another pretrial motion, what must a no-fault claimant show to establish its prima facie case?

This decision: Insufficient: claim forms not shown admissible as business records / merits of claim not proved

Held the provider failed its prima facie showing because its president and biller's affidavit did not establish that the annexed documents were admissible under CPLR 4518.

Proof sufficientMailing/receipt not shownOverdue not shownBusiness-record foundation lackingOther element missingThis decisionCites it or cited by itCited or followed

Of the 1,065 decisions on this question in the Second Department courts and the Court of Appeals, 208 (this one included) are in the same category.

Cited in this decision

A label shows how this decision treated the case it cites.

Art of Healing Medicine, P.C. v Travelers Home & Mar. Ins. Co. (2008 NY Slip Op 07846) FollowedThe providers failed to establish a prima facie case because they did not demonstrate the admissibility of their billing records.
Fortune Med., P.C. v Allstate Ins. Co. (2007 NY Slip Op 50243(U)) FollowedAn insurer's acknowledgment of claim receipt does not concede the admissibility of the claim forms or the facts they contain.

Similar decisions

Careplus Med. Supply, Inc. v Allstate Ins. Co. (2009 NY Slip Op 51398(U))The provider failed to establish a prima facie case because its billing manager's affidavit did not authenticate the supporting records.
Careplus Med. Supply, Inc. v Travelers Indem. Co. (2009 NY Slip Op 51386(U))The provider's motion for summary judgment on the disputed bill was denied for failure to establish admissibility of its documents.
Union Physician Healthcare, P.C. v Utica Mut. Ins. Co. (2009 NY Slip Op 50039(U))The provider failed to establish entitlement to summary judgment because its officer's affidavit lacked a business-record foundation.
Inwood Hill Med., P.C. v Utica Mut. Ins. Co. (2009 NY Slip Op 51129(U))The providers' medical biller failed to establish admissibility of the supporting documents, defeating their motion for summary judgment.
Andromeda Med. Care, P.C. v Utica Mut. Ins. Co. (2009 NY Slip Op 51629(U))The insurer's out-of-state affidavits were inadmissible because their certificates of conformity were defective and the provider objected.