December 18, 2009

Preferred Med. Imaging, P.C. v Countrywide Ins. Co. (2009 NY Slip Op 52577(U))

Headnote

The court considered that the Civil Court granted the petition to vacate an arbitration award and awarded petitioner Preferred Medical Imaging, P.C. unpaid no-fault benefits in the principal sum of $912. The main issue decided was whether the arbitration award was supported by a reasonable hypothesis and was in line with settled law. The holding of the court was that the arbitration award was properly vacated, as the court concluded that it was not "supported by a reasonable hypothesis and was contrary to what could be fairly described as settled law." The court also noted the respondent-appellant's three and a half year delay in perfecting the appeal.

Reported in New York Official Reports at Preferred Med. Imaging, P.C. v Countrywide Ins. Co. (2009 NY Slip Op 52577(U))

Preferred Med. Imaging, P.C. v Countrywide Ins. Co. (2009 NY Slip Op 52577(U)) [*1]

Preferred Med. Imaging, P.C. v Countrywide Ins. Co.

2009 NY Slip Op 52577(U) [25 Misc 3d 144(A)]

Decided on December 18, 2009

Appellate Term, First 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This opinion is uncorrected and will not be published in the printed Official Reports.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 December 18, 2009

APPELLATE TERM OF THE SUPREME COURT, FIRST DEPARTMENT

PRESENT: McKeon, P.J., Heitler, Hunter, JJ
570628/09.

Preferred Medical Imaging, P.C. a/a/o Nathaniel Leach, Petitioner-Respondent,
against
Countrywide Insurance Company, Respondent-Appellant.

Respondent Countrywide Insurance Company appeals from an order of the Civil Court of the City of New York, New York County (Eileen A. Rakower, J.), dated April 27, 2006, which granted the petition to vacate an arbitration award and awarded petitioner Preferred Medical Imaging, P.C. unpaid no-fault benefits in the principal sum of $912.

Per Curiam.

Order (Eileen A. Rakower, J.), dated April 27, 2006, affirmed, without costs.

Civil Court properly vacated the arbitration award issued in an arbitration proceeding commenced by the provider, Preferred Medical Imaging, P.C., to recover first-party no-fault benefits, since the court correctly concluded that the award was not “supported by a reasonable hypothesis and was … contrary to what could be fairly described as settled law” (Matter of State Farm Mut. Auto. Ins. Co. v Lumbermens Mut. Cas. Co., 18 AD3d 762, 763 [2005], citing Matter of Motor Veh. Acc. Indem. Corp. v Aetna Cas. & Sur. Co., 89 NY2d 214, 224 [1996]). The arbitrator’s conclusion, which was sustained by the master arbitrator, that the provider was required to establish the medical necessity of the services rendered was contrary to settled law (see e.g. Mary Immaculate Hosp v Allstate Ins. Co., 5 AD3d 742 [2004]; see also Metro. Radiological Imaging, P.C. v Country-Wide Ins. Co., 19 Misc 3d 130[A] [2008]).Respondent-appellant Countrywide Insurance Company’s remaining contentions are without merit.

We note respondent-appellant’s three and a half year delay in perfecting this appeal.

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
Decision Date: December 18, 2009