February 14, 2011

Park Slope Med. & Surgical Supply, Inc. v GEICO Ins. Co. (2011 NY Slip Op 50188(U))

Headnote

The main issue in this case was whether the medical supplies at issue were medically necessary. The court considered the motion for summary judgment by the plaintiff and the cross motion for summary judgment by the defendant. The defendant submitted peer review reports in support of their motion that stated there was a lack of medical necessity for the supplies. However, the plaintiff's submission of an affirmation of its doctor demonstrated the existence of a question of fact as to medical necessity. Therefore, the court held that there was a triable issue of fact as to the medical necessity of the supplies in question, and the defendant's cross motion for summary judgment was properly denied. The holding was that the sole issue to be determined at trial was the medical necessity of the medical supplies at issue.

Reported in New York Official Reports at Park Slope Med. & Surgical Supply, Inc. v GEICO Ins. Co. (2011 NY Slip Op 50188(U))

Park Slope Med. & Surgical Supply, Inc. v GEICO Ins. Co. (2011 NY Slip Op 50188(U)) [*1]

Park Slope Med. & Surgical Supply, Inc. v GEICO Ins. Co.

2011 NY Slip Op 50188(U) [30 Misc 3d 137(A)]

Decided on February 14, 2011

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This opinion is uncorrected and will not be published in the printed Official Reports.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 14, 2011

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 2nd, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : STEINHARDT, J.P., PESCE and WESTON, JJ
2009-2004 Q C.

Park Slope Medical and Surgical Supply, Inc. as Assignee of MIKHAIL VINITSKY, Respondent,
against
GEICO Ins. Co., Appellant.

Appeal from an order of the Civil Court of the City of New York, Queens County (Carmen R. Velasquez, J.), entered July 7, 2009. The order, insofar as appealed from, in effect, denied defendant’s cross motion for summary judgment.

ORDERED that the order, insofar as appealed from, is affirmed, without 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. The Civil Court, in effect, denied both motions, holding, pursuant to CPLR 3212 (g), that the sole issue to be determined at trial was the medical necessity of the medical supplies at issue. Defendant appeals from so
much of the order as, in effect, denied its cross motion for summary judgment dismissing the complaint.

The papers submitted in support of defendant’s cross motion for summary judgment included two peer review reports in admissible form, both of which set forth a factual basis and medical rationale for the peer reviewers’ opinions that there was a lack of medical necessity for the medical supplies at issue. In opposition to defendant’s cross motion, plaintiff submitted an affirmation of its doctor which sufficiently demonstrated the existence of a question of fact as to medical necessity (see Quality Psychological Servs., P.C. v Mercury Ins. Group, 27 Misc 3d 129[A], 2010 NY Slip Op 50601[U] [App Term, 2d, 11th & 13th Jud Dists 2010]; Park Slope [*2]Med. & Surgical Supply, Inc. v New York Cent. Mut. Fire Ins. Co., 22 Misc 3d 141[A], 2009 NY Slip Op 50441[U] [App Term, 2d, 11th & 13th Jud Dists 2009]). In view of the existence of a triable issue of fact as to the medical necessity of the medical supplies in question, defendant’s cross motion for summary judgment was properly denied (see Zuckerman v City of New York, 49 NY2d 557 [1980]).

Steinhardt, J.P., Pesce and Weston, JJ., concur.
Decision Date: February 14, 2011