November 26, 2013

Rainbow Supply of NY, Inc. v GEICO Gen. Ins. Co. (2013 NY Slip Op 52009(U))

Headnote

The relevant facts considered by the court included a dispute over first-party no-fault benefits between Rainbow Supply of NY, Inc. and GEICO General Insurance Company. The main issue decided was the medical necessity of the medical supply in question. The holding of this case was that the appellate court reversed the lower court's decision and granted GEICO General Insurance Company's cross motion for summary judgment dismissing the complaint. The court based its decision on the fact that defendant's prima facie showing was not rebutted by the plaintiff, and that the only issue for trial was the medical necessity of the supply. The court cited previous cases to support their decision.

Reported in New York Official Reports at Rainbow Supply of NY, Inc. v GEICO Gen. Ins. Co. (2013 NY Slip Op 52009(U))

Rainbow Supply of NY, Inc. v GEICO Gen. Ins. Co. (2013 NY Slip Op 52009(U)) [*1]
Rainbow Supply of NY, Inc. v GEICO Gen. Ins. Co.
2013 NY Slip Op 52009(U) [41 Misc 3d 140(A)]
Decided on November 26, 2013
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This opinion is uncorrected and will not be published in the printed Official Reports.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 November 26, 2013

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


PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ
2011-3161 K C.
Rainbow Supply of NY, Inc. as Assignee of TRACEY WATTS, Respondent, —

against

GEICO General Ins. Co., Appellant.

Appeal from an order of the Civil Court of the City of New York, Kings County (Genine D. Edwards, J.), entered September 13, 2011. The order, insofar as appealed from, denied defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s cross motion for summary judgment dismissing the complaint is granted.

In this action by a provider to recover assigned first-party no-fault benefits, the Civil Court denied plaintiff’s motion for summary judgment and defendant’s cross motion for summary judgment dismissing the complaint, stating that the only issue for trial was the medical necessity of the supply at issue (see CPLR 3212 [g]).

In support of its cross motion, defendant submitted a peer review report and an affidavit executed by the chiropractor who had performed the peer review, which set forth a factual basis and medical rationale for the reviewer’s determination that there was no medical necessity for the medical supply at issue. Defendant’s prima facie showing was not rebutted by plaintiff. Since plaintiff has not challenged the Civil Court’s finding, in effect, that defendant is otherwise entitled to judgment, defendant’s cross motion for summary judgment dismissing the complaint is granted (see Delta Diagnostic Radiology, P.C. v Integon Natl. Ins. Co., 24 Misc 3d 136[A], 2009 NY Slip Op 51502[U] [App Term, 2d, 11th & 13th Jud Dists 2009]; Delta Diagnostic [*2]Radiology, P.C. v American Tr. Ins. Co., 18 Misc 3d 128[A], 2007 NY Slip Op 52455[U] [App Term, 2d & 11th Jud Dists 2007]; A. Khodadadi Radiology, P.C. v NY Cent. Mut. Fire Ins. Co., 16 Misc 3d 131[A], 2007 NY Slip Op 51342[U] [App Term, 2d & 11th Jud Dists 2007]).

Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: November 26, 2013