October 12, 2011
PMR Physical Therapy v GEICO Gen. Ins. Co. (2011 NY Slip Op 51852(U))
https://www.beynensonlaw.com/case-law/pmr-physical-therapy-v-geico-gen-ins-co-2011-ny-slip-op-51852u/
- Decided
- October 12, 2011
- Citation
- 2011 NY Slip Op 51852(U) · 33 Misc 3d 129(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Legal questions
- Claimant's prima facie case on motions (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 PMR Physical Therapy v GEICO Gen. Ins. Co. (2011 NY Slip Op 51852(U))
| PMR Physical Therapy v GEICO Gen. Ins. Co. |
| 2011 NY Slip Op 51852(U) [33 Misc 3d 129(A)] |
| Decided on October 12, 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
SUPREME COURT OF THE STATE OF NEW YORK
APPELLATE TERM: 2nd, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., RIOS and STEINHARDT, JJ
2010-433 K C.
against
GEICO General Ins. Co., Respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Peter Paul Sweeney, J.), entered September 30, 2009. The order denied plaintiff’s motion for summary judgment.
ORDERED that 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 denying its unopposed motion for summary judgment.
“Plaintiff’s motion for summary judgment was supported by an affidavit of the president of a third-party billing company, who did not demonstrate that he possessed personal knowledge of plaintiff’s business practices and procedures to establish that the documents annexed to plaintiff’s motion papers constituted evidence in admissible form pursuant to CPLR 4518. As a result, plaintiff failed to make a prima facie showing of its entitlement to summary judgment” (PMR Physical Therapy v Country-Wide Ins. Co., 20 Misc 3d 127[A], 2010 NY Slip Op 51729[U] [App Term, 2d, 11th & 13th Jud Dists 2010]; see Matter of Carothers v GEICO Indem. Co., 79 AD3d 864 [2010]; Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 31 Misc 3d 21 [App Term, 2d, 11th & 13th Jud Dists 2011]).
Accordingly, the order is affirmed.
Pesce, P.J., Rios and Steinhardt, JJ., concur.
Decision Date: October 12, 2011
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.
On summary judgment or another pretrial motion, what must a no-fault claimant show to establish its prima facie case?
This decision: Insufficient: claim forms not shown admissible as business records / merits of claim not proved
Held the provider's unopposed motion properly denied because the third-party biller lacked personal knowledge of the provider's practices to make the annexed documents admissible under CPLR 4518.
Of the 1,065 decisions on this question in the Second Department courts and the Court of Appeals, 208 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- PMR Physical Therapy v Country-Wide Ins. Co. (2010 NY Slip Op 51729(U)) FollowedThe provider failed to establish admissible billing records because its third-party biller lacked demonstrated knowledge of its business practices.
- Matter of Carothers v GEICO Indem. Co. (2010 NY Slip Op 09256) FollowedThe provider's billing witness failed to establish a business-records foundation for claim forms merely printed and mailed by the billing company.
- Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co. (2011 NY Slip Op 21039) FollowedThe provider failed to establish its prima facie case because its third-party biller's affidavit lacked a business-record foundation.
Similar decisions
- A.B. Med., PLLC v GEICO (2013 NY Slip Op 50203(U))The provider failed to establish that the insurer's denials were untimely or without merit as a matter of law.
- City Wide Social Work & Psychological Servs., PLLC v GEICO Gen. Ins. Co. (2007 NY Slip Op 50603(U))The provider's employee affidavits failed to establish a business-records foundation for the claim at issue on appeal.
- Axis Chiropractic, PLLC v GEICO Gen. Ins. Co. (2010 NY Slip Op 51339(U))The provider's billing-company affiant failed to show personal knowledge needed to establish a business-record foundation.
- Comprehensive Care Physical Therapy, P.C. v GEICO Ins. Co. (2019 NY Slip Op 52069(U))The provider's summary judgment motion was denied and the insurer's cross motion dismissing the complaint for EUO nonappearance was granted.
- New York Diagnostic Med. Care, P.C. v GEICO Gen. Ins. Co. (2013 NY Slip Op 50419(U))The provider's doctor's affidavit raised a factual issue on medical necessity, defeating the insurer's cross motion for summary judgment.