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February 16, 2024

LR Med., PLLC v Nationwide Ins. Co. (2024 NY Slip Op 50204(U))

https://www.beynensonlaw.com/case-law/lr-med-pllc-v-nationwide-ins-co-2024-ny-slip-op-50204u/

Court
Appellate Term, Second Department
Decided
February 16, 2024
Citation
2024 NY Slip Op 50204(U)
Posture
Summary judgment
Outcome
Split result
Issues
Policy issues
Cite as
LR Med., PLLC v Nationwide Ins. Co., 2024 NY Slip Op 50204(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2024)

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 insurer's summary judgment motion based on policy exhaustion was denied on appeal. The Appellate Term, Second Department, modified the order and affirmed denial of the provider's cross motion. It relied on the reasons stated in JSJ Anesthesia Pain Mgt., PLLC v Nationwide Ins. Co., the companion appeal decided the same day, No. 2023-655 K C.

Reported in New York Official Reports at LR Med., PLLC v Nationwide Ins. Co. (2024 NY Slip Op 50204(U))

[*1]
LR Med., PLLC v Nationwide Ins. Co.
2024 NY Slip Op 50204(U)
Decided on February 16, 2024
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This opinion is uncorrected and will not be published in the printed Official Reports.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 February 16, 2024
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : CHEREÉ A. BUGGS, J.P., LISA S. OTTLEY, PHILLIP HOM, JJ
2023-656 K C

LR Medical, PLLC, as Assignee of Gardner-Bowlyn, Janet, Appellant,

against

Nationwide Insurance Company, Respondent.


The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Law Offices of Brian Rayhill (Ivy Cherian and Lawrence Wolkow of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Keisha M. Alleyne, J.), dated April 10, 2023. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross-motion for summary judgment.

ORDERED that the order is modified by providing that defendant’s motion for summary judgment dismissing the complaint is denied; as so modified, the order is affirmed, without costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court granting defendant’s motion for summary judgment dismissing the complaint on the ground that the policy limits had been exhausted, and denying plaintiff’s cross-motion for summary judgment.

For the reasons stated in JSJ Anesthesia Pain Mgt., PLLC, as Assignee of Gardner-Bowlyn, Janet v Nationwide Ins. Co. (— Misc 3d —, 2024 NY Slip Op — [appeal No. 2023-655 K C], decided herewith), the order is modified by providing that defendant’s motion for summary judgment dismissing the complaint is denied.

BUGGS, J.P., OTTLEY and HOM, JJ., concur.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: February 16, 2024

Similar decisions

  • JSJ Anesthesia Pain Mgt., PLLC v Nationwide Ins. Co. (2024 NY Slip Op 50203(U))The insurer failed to prove policy exhaustion because its claim specialist did not lay a sufficient foundation for the payment log.
  • JPF Med. Servs., P.C. v Nationwide Ins. (2020 NY Slip Op 51122(U))The insurer failed to prove policy exhaustion because its payment log lacked a sufficient business-record foundation.
  • Chiropractic Assoc. of Richmond Hill, P.C. v Nationwide Gen. Ins. Co. (2025 NY Slip Op 50506(U))The insurer failed to establish that policy limits were exhausted before it received the provider's completed claims.
  • MSB Physical Therapy, P.C. v Nationwide Ins. (2023 NY Slip Op 50284(U))The insurer's summary judgment dismissing the provider's assigned no-fault claims was affirmed, and the provider's cross motion remained denied.
  • MSB Physical Therapy v Nationwide Ins. (2022 NY Slip Op 51381(U))The insurer failed to establish timely denial after alleged EUO nonappearances, and the provider failed to establish entitlement to summary judgment.
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