May 11, 2012

Raz Acupuncture, P.C. v New S. Ins. Co. (2012 NY Slip Op 50865(U))

Headnote

The relevant facts considered by the court in this case were that Raz Acupuncture, P.C. was seeking to recover assigned first-party no-fault benefits from New South Ins. Co. The court considered the denial of plaintiff's claims on the ground that the unpaid portion exceeded the amount permitted by the workers' compensation fee schedule. The main issue decided by the court was whether defendant had timely denied plaintiff's claims and whether it had fully paid the plaintiff for the services in accordance with the workers' compensation fee schedule. The holding of the case was that the order, insofar as appealed from, was affirmed, as defendant had timely denied plaintiff's claims and had fully paid plaintiff for the services in accordance with the workers' compensation fee schedule.

Reported in New York Official Reports at Raz Acupuncture, P.C. v New S. Ins. Co. (2012 NY Slip Op 50865(U))

Raz Acupuncture, P.C. v New S. Ins. Co. (2012 NY Slip Op 50865(U)) [*1]

Raz Acupuncture, P.C. v New S. Ins. Co.

2012 NY Slip Op 50865(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This opinion is uncorrected and will not be published in the printed Official Reports.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: : WESTON, J.P., PESCE and RIOS, JJ
2010-1714 K C.

Raz Acupuncture, P.C. as Assignee of DAVID MATATOV, Appellant, —
against
New South Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Wavny Toussaint, J.), entered August 14, 2009. The order, insofar as appealed from as limited by the brief, granted the branches of defendant’s cross motion seeking summary judgment dismissing the first, second, third and fifth causes of action.

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 appeals, as limited by its brief, from so much of an order of the Civil Court as granted the branches of defendant’s cross motion seeking summary judgment dismissing the first, second, third and fifth causes of action.

The affidavits submitted by defendant in support of its cross motion for summary judgment established that defendant had timely denied (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]) plaintiff’s claims on the ground that the unpaid portion exceeded the amount permitted by the workers’ compensation fee [*2]schedule. Moreover, defendant demonstrated that it had fully paid plaintiff for the services in accordance with the workers’ compensation fee schedule (see Great Wall Acupuncture, P.C. v GEICO Ins. Co., 26 Misc 3d 23 [App Term, 2d, 11th & 13th Jud Dists 2009]). Accordingly, the order, insofar as appealed from, is affirmed.

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