August 5, 2015

North Bronx Med. Health Care v Praetorian Ins. Co. (2015 NY Slip Op 51231(U))

Headnote

The court considered a motion for summary judgment in a case where a medical provider was seeking to recover first-party no-fault benefits from an insurance company. The insurance company argued that there was a lack of medical necessity for the treatment provided. The main issue decided by the court was whether there were triable issues of fact regarding the defense of lack of medical necessity. The court held that there were indeed triable issues of fact, and therefore, the insurance company's motion for summary judgment was denied. The order of the Civil Court denying the motion for summary judgment was affirmed by the Appellate Term.

Reported in New York Official Reports at North Bronx Med. Health Care v Praetorian Ins. Co. (2015 NY Slip Op 51231(U))

North Bronx Med. Health Care v Praetorian Ins. Co. (2015 NY Slip Op 51231(U)) [*1]

North Bronx Med. Health Care v Praetorian Ins. Co.

2015 NY Slip Op 51231(U) [48 Misc 3d 140(A)]

Decided on August 5, 2015

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This opinion is uncorrected and will not be published in the printed Official Reports.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 August 5, 2015

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-994 Q C

North Bronx Medical Health Care as Assignee of JENNIFER PAREDES, Respondent, August 5, 2015
against
Praetorian Ins. Co., Appellant.

Appeal from an order of the Civil Court of the City of New York, Queens County (Barry A. Schwartz, J.), entered March 28, 2013. The order denied defendant’s motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court which denied defendant’s motion for summary judgment dismissing the complaint.

A review of the record reveals that there are triable issues of fact regarding defendant’s defense of lack of medical necessity. Consequently, defendant’s motion was properly denied (see Zuckerman v City of New York, 49 NY2d 557 [1980]).

Accordingly, the order is affirmed.

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

Decision Date: August 05, 2015