January 26, 2011
Sung Bok Lee v Metropolitan Prop. & Cas. Ins. Co. (2011 NY Slip Op 50110(U))
https://www.beynensonlaw.com/case-law/sung-bok-lee-v-metropolitan-prop-cas-ins-co-2011-ny-slip-op50110u/
- Decided
- January 26, 2011
- Citation
- 2011 NY Slip Op 50110(U) · 30 Misc 3d 135(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Issues
- Fee schedule
- Legal questions
- Proving a fee schedule defense (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 Sung Bok Lee v Metropolitan Prop. & Cas. Ins. Co. (2011 NY Slip Op 50110(U))
| Sung Bok Lee v Metropolitan Prop. & Cas. Ins. Co. |
| 2011 NY Slip Op 50110(U) [30 Misc 3d 135(A)] |
| Decided on January 26, 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| This opinion is uncorrected and will not be published in the printed Official Reports.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: : STEINHARDT, J.P., PESCE and WESTON, JJ
2009-1919 Q C.
against
METROPOLITAN PROPERTY AND CASUALTY INS. CO., Respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Diane A. Lebedeff, J.), entered July 17, 2009, deemed from a judgment of the same court entered August 18, 2009 (see CPLR 5501 [c]). The judgment, entered pursuant to the July 17, 2009 order granting defendant’s motion for summary judgment, dismissed the complaint.
ORDERED that the judgment is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground that it had properly reimbursed plaintiff for services rendered by its licensed acupuncturist to plaintiff’s assignor. Plaintiff opposed the motion. The Civil Court granted defendant’s motion and dismissed the complaint. This appeal by plaintiff ensued. A judgment was subsequently entered, from which the appeal is deemed to be taken (see CPLR 5501 [c]).
It was proper for defendant to use the workers’ compensation fee schedule for acupuncture services performed by chiropractors to determine the amount which plaintiff was entitled to receive for services rendered by a licensed acupuncturist (see AVA Acupuncture, P.C. v GEICO Gen. Ins. Co., 17 Misc 3d 41 [App Term, 2d & 11th Jud Dists 2007]; Great Wall Acupuncture v GEICO Gen. Ins. Co., 16 Misc 3d 23 [App Term, 2d & 11th Jud Dists 2007]). As defendant’s motion for summary judgment dismissing the complaint was properly granted, the judgment is affirmed.
Steinhardt, J.P., Pesce and Weston, JJ., concur.
Decision Date: January 26, 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.
Did the insurer prove that the amount billed exceeded the applicable workers’ compensation fee schedule?
This decision: Insurer proved the billed amount exceeded the applicable fee schedule
Held the insurer properly reimbursed the licensed acupuncturist at the chiropractor acupuncture fee schedule rate, so summary judgment dismissing the complaint was correct.
Of the 284 decisions on this question in the Second Department courts and the Court of Appeals, 146 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- AVA Acupuncture, P.C. v GEICO Gen. Ins. Co. (2007 NY Slip Op 27371) FollowedAn insurer may use the workers' compensation fee schedule for chiropractors to reimburse acupuncture performed by a licensed acupuncturist.
- Great Wall Acupuncture v GEICO Gen. Ins. Co. (2007 NY Slip Op 27164) FollowedThe insurer properly reimbursed the licensed acupuncturist at chiropractor rates because similar services and licensing requirements supported them.
Similar decisions
- Gentle Care Acupuncture, P.C. v GEICO (2011 NY Slip Op 51121(U))An insurer may use the workers' compensation fee schedule for chiropractors' acupuncture services to reimburse a licensed acupuncturist.
- AVA Acupuncture, P.C. v GEICO Gen. Ins. Co. (2009 NY Slip Op 51017(U))Acupuncture services rendered by a licensed acupuncturist may be reimbursed at the workers' compensation fee schedule rate for chiropractors.
- GL Acupuncture, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51698(U))The insurer established timely denial and full payment under the fee schedule for acupuncture services performed by chiropractors.
- Gl Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2013 NY Slip Op 51748(U))The insurer established full payment at the workers' compensation fee-schedule rate for chiropractic acupuncture.
- BQE Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2019 NY Slip Op 51260(U))An insurer may use the workers' compensation fee schedule for acupuncture by chiropractors to reimburse a licensed acupuncturist.