May 11, 2012

Raz Acupuncture, P.C. v Nationwide Mut. Ins. Co. (2012 NY Slip Op 50871(U))

Headnote

The court considered an order from the Civil Court of the City of New York, Kings County, which granted the defendant's motion for summary judgment dismissing the complaint as to services rendered to Natalia Agudelo and Maria Salazar. The main issue decided was whether the defendant had timely denied the claims based upon the workers' compensation fee schedule, and the court implicitly found that they had. The holding of the case was that the order, insofar as appealed from, was affirmed, without costs. The court found that the plaintiff's argument, that the defendant failed to demonstrate that it had fully paid the plaintiff for the acupuncture services at issue in accordance with the workers' compensation fee schedule, lacked merit. Additionally, the plaintiff's remaining contention was not considered as it was based upon material that was dehors the record.

Reported in New York Official Reports at Raz Acupuncture, P.C. v Nationwide Mut. Ins. Co. (2012 NY Slip Op 50871(U))

Raz Acupuncture, P.C. v Nationwide Mut. Ins. Co. (2012 NY Slip Op 50871(U)) [*1]

Raz Acupuncture, P.C. v Nationwide Mut. Ins. Co.

2012 NY Slip Op 50871(U) [35 Misc 3d 140(A)]

Decided on May 11, 2012

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This opinion is uncorrected and will not be published in the printed Official Reports.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 May 11, 2012

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

PRESENT: : PESCE, P.J., RIOS and ALIOTTA, JJ
2010-1967 K C.

Raz Acupuncture, P.C. as Assignee of NATALIA AGUDELO and MARIA SALAZAR, Appellant, —
against
Nationwide Mutual Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Margaret A. Pui Yee Chan, J.), entered October 23, 2009. The order, insofar as appealed from as limited by the brief, granted the branches of defendant’s motion seeking summary judgment dismissing the complaint as to services rendered to Natalia Agudelo from September 11, 2006 to November 16, 2006 and as to services rendered to Maria Salazar from November 11, 2006 to November 15, 2006.

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, the Civil Court granted the branches of defendant’s motion seeking summary judgment dismissing the complaint as to services rendered to Natalia Agudelo from September 11, 2006 to November 16, 2006 and as to services rendered to Maria Salazar from November 11, 2006 to November 15, 2006, implicitly finding that defendant had timely denied these claims based upon the workers’ compensation fee schedule.

Plaintiff’s argument that defendant failed to demonstrate that it had fully paid plaintiff for [*2]the acupuncture services at issue in accordance with the workers’ compensation fee schedule lacks merit. Plaintiff’s remaining contention is, as plaintiff concedes, based upon material that is dehors the record, and will not be considered.

Accordingly, the order, insofar as appealed from, is affirmed.

Pesce, P.J., Rios and Aliotta, JJ., concur.
Decision Date: May 11, 2012