April 30, 2014

New Way Med. Supply Corp. v Geico Ins. Co. (2014 NY Slip Op 50776(U))

Headnote

The relevant facts the court considered in this case were that New Way Medical Supply Corp., as the assignee of JESULA ST. VICTOR, was seeking to recover assigned first-party no-fault benefits from Geico Ins. Co. Plaintiff moved for summary judgment, and defendant cross-moved for summary judgment on the basis that the claim was denied due to a lack of medical necessity. The Civil Court denied plaintiff's motion and made findings in plaintiff's favor, denying defendant's cross motion and holding that the only remaining issue for trial was medical necessity. The main issue decided in the case was whether there was a triable issue of fact regarding the medical necessity of the services at issue. The holding of the case was that the order, insofar as appealed from, was affirmed, with the court finding that there was a triable issue of fact regarding the medical necessity of the services at issue.

Reported in New York Official Reports at New Way Med. Supply Corp. v Geico Ins. Co. (2014 NY Slip Op 50776(U))

New Way Med. Supply Corp. v Geico Ins. Co. (2014 NY Slip Op 50776(U))
New Way Med. Supply Corp. v Geico Ins. Co.
2014 NY Slip Op 50776(U) [43 Misc 3d 138(A)]
Decided on April 30, 2014
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This opinion is uncorrected and will not be published in the printed Official Reports.

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-1188 K C
New Way Medical Supply Corp. as Assignee of JESULA ST. VICTOR, Respondent,

against

Geico Ins. Co., Appellant.

[*1]

Appeal from an order of the Civil Court of the City of New York, Kings County (Harriet L. Thompson, J.), entered March 26, 2012. The order, insofar as appealed from, upon denying plaintiff’s motion for summary judgment, made, in effect, CPLR 3212 (g) findings in plaintiff’s favor, and denied defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment, and defendant cross-moved for summary judgment dismissing the complaint on the ground that it had timely and properly denied the claim at issue based on a lack of medical necessity. Insofar as is relevant to this appeal, the Civil Court, upon denying plaintiff’s motion, made CPLR 3212 (g) findings in plaintiff’s favor, denied defendant’s cross motion, and held that the only remaining issue for trial was medical necessity.

For the reasons stated in EMC Health Prods., Inc. as Assignee of Brian Byers v Geico Ins. Co. (___ Misc 3d ___, 2014 NY Slip Op _____ [Appeal No. 2012-1208 K C], decided herewith), we find that defendant failed to articulate a sufficient basis to strike the Civil Court’s CPLR 3212 (g) findings in plaintiff’s favor. Moreover, upon a review of the record, we find that there is a triable issue of fact regarding the medical necessity of the services at issue.

Accordingly, the order, insofar as appealed from, is affirmed.

Pesce, P.J., Aliotta and Solomon, JJ., concur.


Decision Date: April 30, 2014