June 18, 2009

Life Chiropractic, P.C. v Farm Family Cas. Ins. Co. (2009 NY Slip Op 52822(U))

https://www.beynensonlaw.com/case-law/life-chiropractic-p-c-v-farm-family-cas-ins-co-2009-ny-slip-op52822u/

Court: Appellate Term, Second Department
Decided: June 18, 2009
Citation: 2009 NY Slip Op 52822(U) · 34 Misc 3d 138(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

Life Chiropractic, P.C. v Farm Family Cas. Ins. Co., 34 Misc 3d 138(A), 2009 NY Slip Op 52822(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's billing-manager affidavit failed to establish admissibility of its supporting documents under CPLR 4518. The provider moved for summary judgment in an action to recover assigned first-party no-fault benefits. The insurer opposed the motion, arguing that the affidavit did not establish that the annexed claim form was admissible evidence. The Appellate Term, Second Department, affirmed denial of the provider's motion because the affidavit did not lay the required business-record foundation for the documents annexed to the moving papers. Without admissible supporting documents, the provider failed to make a prima facie showing of entitlement to summary judgment.

Reported in New York Official Reports at Life Chiropractic, P.C. v Farm Family Cas. Ins. Co. (2009 NY Slip Op 52822(U))

[*1]

Life Chiropractic, P.C. v Farm Family Cas. Ins. Co.

2009 NY Slip Op 52822(U) [34 Misc 3d 138(A)]

Decided on June 18, 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This opinion is uncorrected and will not be published in the printed Official Reports.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 18, 2009

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 9th and 10th JUDICIAL DISTRICTS

PRESENT: : TANENBAUM, J.P., MOLIA and SCHEINKMAN, JJ
2008-1437 N C.

Life Chiropractic, P.C. a/a/o REGINALD WOODEN, Appellant,
against
Farm Family Casualty Insurance Company, Respondent.

Appeal from an order of the District Court of Nassau County, Third District (Rhonda E. Fischer, J.), entered June 11, 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 plaintiff’s supporting affidavit failed to establish that the annexed claim form constituted evidence in admissible form. The District Court denied plaintiff’s motion. Plaintiff appeals and we affirm.

Plaintiff failed to make a prima facie showing of its entitlement to summary judgment since the affidavit submitted by plaintiff’s billing manager failed to establish that the documents annexed to plaintiff’s moving papers were admissible pursuant to CPLR 4518 (see 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. Accordingly, the order is affirmed.

Tanenbaum, J.P., and Molia, J., concur.

Scheinkman, J., taking no part.
Decision Date: June 18, 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 to make a prima facie showing because its billing manager's affidavit did not establish that the annexed claim documents were admissible as business records 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 990 decisions on this question in the Second Department courts and the Court of Appeals, 206 (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

Craigg Total Health Family Chiropractic Care, P.C. v QBE Ins. Corp. (2009 NY Slip Op 51400(U))The providers failed to establish a prima facie case because their billing manager's affidavit did not authenticate the supporting records.
RLC Med., P.C. v Allstate Ins. Co. (2009 NY Slip Op 51131(U))The provider's billing manager failed to establish admissible business records, defeating the provider's motion for summary judgment.
A.B. Med. Servs., PLLC v Country-Wide Ins. Co. (2009 NY Slip Op 51130(U))The providers' medical biller failed to establish admissibility of the supporting documents, defeating their motion for summary judgment.
Island Life Chiropractic, P.C. v 21st Century Ins. Co. (2017 NY Slip Op 51820(U))The provider failed to establish that its claims were denied late or that timely denials were conclusory, vague or legally meritless.
A.B. Med. Servs., PLLC v American Tr. Ins. Co. (2009 NY Slip Op 51261(U))The providers failed to establish a prima facie case because their billing manager's affidavit did not establish admissible business records.