June 10, 2022
MSB Physical Therapy, P.C. v Nationwide Ins. (2022 NY Slip Op 50564(U))
https://www.beynensonlaw.com/case-law/msb-physical-therapy-p-c-v-nationwide-ins-2022-ny-slip-op-50564u/
- Decided
- June 10, 2022
- Citation
- 2022 NY Slip Op 50564(U) · 75 Misc 3d 136(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Later treatment
- Followed in 1 later decision (see Cited by)
- Legal questions
- No-show defense: insurer's proof (see the maps)
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.
Reported in New York Official Reports at MSB Physical Therapy, P.C. v Nationwide Ins. (2022 NY Slip Op 50564(U))
| MSB Physical Therapy, P.C. v Nationwide Ins. |
| 2022 NY Slip Op 50564(U) [75 Misc 3d 136(A)] |
| Decided on June 10, 2022 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports.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 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2019-1349 K C
against
Nationwide Ins., Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Hollander Legal Group, P.C. (Allan S. Hollander of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin S. Garson, J.), dated June 28, 2019. 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 affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order which granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
Contrary to plaintiff’s sole appellate contention with respect to defendant’s motion for summary judgment, defendant did not need to demonstrate, as part of its prima facie case, that the first examination under oath scheduling letter had been sent to plaintiff’s assignor within 15 days of defendant’s receipt of either the NF-2 or a claim received from another provider (see Interboro Ins. Co. v Clennon, 113 AD3d 596, 597 [2014]; Excel Prods., Inc. v Ameriprise Auto & Home, 71 Misc 3d 136[A], 2021 NY Slip Op 50435[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]; see also State Farm Mut. Auto. Ins. Co. v Surgicore of Jersey City, LLC, 195 AD3d 454 [2021]).
Accordingly, the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
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.
Did the insurer prove its IME/EUO no-show defense: mailed, compliant scheduling requests and the claimant’s nonappearance?
This decision: Insurer proved mailed, compliant requests and the nonappearance; claimant's answers rejected
The court rejected the provider's sole contention that the insurer had to show its first EUO scheduling letter was sent within 15 days of receiving the NF-2 or another provider's claim, and affirmed summary judgment for the insurer.
Of the 858 decisions on this question in the Second Department courts and the Court of Appeals, 527 (this one included) are in the same category. One decision in other departments that cites or is cited by this one is on the full map.
Cited in this decision
- Interboro Ins. Co. v Clennon (2014 NY Slip Op 00092)The assignor's two EUO nonappearances supported a declaration that the providers were not entitled to no-fault benefits.
- State Farm Mut. Auto. Ins. Co. v Surgicore of Jersey City, LLC (2021 NY Slip Op 03536)The insurer established entitlement to a default declaration of noncoverage based on a founded belief that the collision was staged.
Cited by
A label shows how the later decision treated this one.
- MSB Physical Therapy, P.C. v Nationwide Ins. (2023 NY Slip Op 50284(U)) FollowedThe insurer's summary judgment dismissing the provider's assigned no-fault claims was affirmed, and the provider's cross motion remained denied.
Similar decisions
- 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.
- PFJ Med. Care, P.C. v Nationwide Ins. (2022 NY Slip Op 50570(U))The insurer's counsel affirmations and EUO transcripts established the provider's failure to appear for EUOs. In this action for assigned first-party no-fault benefits, the provider appealed the denial of its summary judgment motion and the grant of the insurer's cross motion dismissing the complaint.
- New York Manual, P.T., P.C. v Nationwide Affinity Ins. Co. of Am. (2023 NY Slip Op 50281(U))The provider failed to raise a triable issue that it supplied requested verification or reasonably justified noncompliance.
- NY Wellness Med., P.C. v Nationwide Mut. Ins. Co. (2022 NY Slip Op 50359(U))An insurer need not set forth objective reasons for requesting EUOs to establish prima facie entitlement to summary judgment.
- Masigla v Nationwide Ins. (2022 NY Slip Op 50575(U))The insurer's motion for summary judgment dismissing the provider's no-fault complaint was granted and the provider's cross motion was denied.