January 2, 2007

V.S. Med. Servs. P.C. v Allstate Ins. Co. (2007 NY Slip Op 50016(U))

https://www.beynensonlaw.com/case-law/v-s-med-servs-p-c-v-allstate-ins-co-2007-ny-slip-op-50016u/

Court: Appellate Term, Second Department
Decided: January 2, 2007
Citation: 2007 NY Slip Op 50016(U) · 14 Misc 3d 130(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Assignments and standing

Cite as

V.S. Med. Servs. P.C. v Allstate Ins. Co., 14 Misc 3d 130(A), 2007 NY Slip Op 50016(U) (App Term, 2d Dept, 2d & 11th Jud Dists 2007)

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.

A billing provider cannot recover assigned no-fault benefits for services rendered by independent contractors. The provider sought summary judgment in an action to recover first-party no-fault benefits, but its claim form identified the treating professionals as independent contractors. Under 11 NYCRR 65-3.11 (a), a billing entity is not the provider of services rendered by independent contractors rather than by the entity or its employees and cannot receive direct payment of assigned benefits. The Appellate Term, Second Department, affirmed the denial of the provider's motion.

Reported in New York Official Reports at V.S. Med. Servs. P.C. v Allstate Ins. Co. (2007 NY Slip Op 50016(U))

[*1]

V.S. Med. Servs. P.C. v Allstate Ins. Co.

2007 NY Slip Op 50016(U) [14 Misc 3d 130(A)]

Decided on January 2, 2007

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This opinion is uncorrected and will not be published in the printed Official Reports.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 January 2, 2007

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 2nd and 11th JUDICIAL DISTRICTS

PRESENT:: PESCE, P.J., WESTON PATTERSON and BELEN, JJ
2006-150 Q C.

V.S. Medical Services P.C. a/a/o Susana Jimenez, Appellant,
against
Allstate Insurance Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Anna Culley, J.), entered June 6, 2005. The order denied plaintiff’s motion for summary judgment.

Order affirmed without costs.

Plaintiff commenced the instant action seeking to recover first-party no-fault benefits for medical services rendered to its assignor in the sum of $3,836.20. Where a billing provider seeks to recover no-fault benefits for services which were not rendered by it or its employees, but rather by a treating provider who is an independent
contractor, it is not a “provider” of the medical services rendered within the meaning of 11 NYCRR 65-3.11 (a) and is therefore not entitled to recover “direct payment” of assigned no-fault benefits from the defendant insurer (Health & Endurance Med. P.C. v State Farm Mut. Auto. Ins. Co., 12 Misc 3d 134[A], 2006 NY Slip Op 51191[U] [App Term, 2d & 11th Jud Dists]; Craig Antell, D.O., P.C. v New York Cent. Mut. Fire Ins. Co., 11 Misc 3d 137[A], 2006 NY Slip Op 50521[U] [App Term, 1st Dept]; A.B. Med. Servs. PLLC v Liberty Mut. Ins. Co., 9 Misc 3d 36 [App Term, 2d & 11th Jud Dists 2005]; A.B. Med. Servs. PLLC v New York Cent. Mut. Fire Ins. Co., 8 Misc 3d 132[A], 2005 NY Slip Op 51111[U] [App Term, 2d & 11th Jud Dists]). In the case at bar, plaintiff’s claim form states that the treating professionals were independent contractors. Under the circumstances, plaintiff’s motion for summary judgment was properly denied.

Pesce, P.J., Weston Patterson and Belen, JJ., concur.
Decision Date: January 2, 2007

Cited in this decision

Health & Endurance Med. P.C. v State Farm Mut. Auto. Ins. Co. (2006 NY Slip Op 51191(U))A billing provider cannot recover assigned no-fault benefits for services rendered by an independent contractor rather than its employees.
Craig Antell, D.O., P.C. v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 50521(U))A billing provider cannot receive assigned no-fault benefits for services performed by an independent contractor rather than itself or its employees.
A.B. Med. Servs. PLLC v Liberty Mut. Ins. Co. (2005 NY Slip Op 25277)A billing provider cannot recover assigned no-fault benefits directly for services rendered by an independent contractor.
A.B. Med. Servs. PLLC v New York Cent. Mut. Fire Ins. Co. (2005 NYSlipOp 51111(U))A billing provider cannot recover assigned no-fault benefits for services performed by an independent contractor rather than by it or its employees.

Cited by

A.M. Med. Servs., P.C. v Progressive Cas. Ins. Co. (2012 NY Slip Op 06902)An insurer's independent contractor defense is subject to preclusion if not asserted in a timely denial of claim.

Similar decisions

V.S. Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 52553(U))A billing provider cannot recover direct assigned no-fault payments for services rendered by independent contractors rather than its employees.
Health & Endurance Med., P.C. v Liberty Mut. Ins. Co. (2008 NY Slip Op 50864(U))A billing provider cannot recover direct payment of assigned no-fault benefits for services rendered by an independent contractor.
V.S. Med. Servs., P.C. v New York Cent. Mut. Ins. (2007 NY Slip Op 51080(U))The provider's summary judgment motion failed because its officer's affidavit did not establish a business-records foundation.
V.S. Med. Servs., P.C. v Allstate Ins. Co. (2007 NY Slip Op 50400(U))The provider failed to prove claim submission because its corporate officer's affidavit lacked a sufficient business-records foundation.
Boai Zhong Yi Acupuncture Servs. P.C. v Allstate Ins. Co. (2006 NY Slip Op 51288(U))A billing provider cannot recover direct payment of assigned no-fault benefits for services rendered by an independent contractor.