Reported in New York Official Reports at Charles Deng Acupuncture, P.C. v Nationwide Ins. (2022 NY Slip Op 50580(U))
Charles Deng Acupuncture, P.C. v Nationwide Ins. |
2022 NY Slip Op 50580(U) [75 Misc 3d 138(A)] |
Decided on June 10, 2022 |
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This opinion is uncorrected and will not be published in the printed Official Reports.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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-300 K C
against
Nationwide Ins., Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Hollander Legal Group, P.C. (Allan S. Hollander of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered August 8, 2019. The order granted defendant’s motion for summary judgment dismissing the complaint.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant’s motion for summary judgment dismissing the complaint.
Plaintiff’s arguments as to why defendant’s motion for summary judgment should have been denied are not properly before this court, since they are being raised for the first time on appeal, and we decline to consider them (see Joe v Upper Room Ministries, Inc., 88 AD3d 963 [2011]; Gulf Ins. Co. v Kanen, 13 AD3d 579 [2004]).
Accordingly, the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Mega Aid Pharm. I, Inc. v A. Cent. Ins. Co. (2022 NY Slip Op 50579(U))
Mega Aid Pharm. I, Inc. v A. Cent. Ins. Co. |
2022 NY Slip Op 50579(U) [75 Misc 3d 138(A)] |
Decided on June 10, 2022 |
Appellate Term, Second Department |
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
As corrected in part through July 8, 2022; it will not be published in the printed Official Reports. |
Decided on June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-181 K C
against
A. Central Insurance Company, Appellant.
Nightingale Law, P.C. (Michael S. Nightingale of counsel), for appellant. Zara Javakov, P.C. (Zara Javakov of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Rosemarie Montalbano, J.), entered September 16, 2019. The order, insofar as appealed from, denied defendant’s motion for summary judgment dismissing the complaint.
ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s motion for summary judgment dismissing the complaint is granted.
In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from so much of an order of the Civil Court as denied defendant’s motion which had sought summary judgment dismissing the complaint on the grounds that plaintiff’s claims were submitted more than 45 days after the subject supplies had been furnished, lack of medical necessity, and that the fees sought exceeded the amounts permitted by the workers’ compensation fee schedule.
The affidavit of defendant’s claims representative established that the claims at issue had been submitted more than 45 days after those supplies had been furnished (see 11 NYCRR 65-1.1) and that defendant had timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) its denial of claim form, which denied the claim on that ground. Furthermore, defendant’s denial of claim form advised plaintiff that late notice would be excused if reasonable justification for the failure to give timely notice was provided (11 NYCRR 65-1.1). Plaintiff failed to raise a triable issue of fact in response to defendant’s prima facie showing. Indeed, the claim forms annexed to a cross motion for summary judgment by plaintiff were dated more than 45 days after the supplies at issue were furnished. In light of the foregoing, defendant’s motion for summary judgment dismissing the complaint should have been granted. We reach no other issue.
Accordingly, the order, insofar as appealed from, is reversed, and defendant’s motion for [*2]summary judgment dismissing the complaint is granted.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Lida’s Med. Supply, Inc. v Personal Serv. Ins. Co. (2022 NY Slip Op 50578(U))
Lida’s Med. Supply, Inc. v Personal Serv. Ins. Co. |
2022 NY Slip Op 50578(U) [75 Misc 3d 138(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-174 K C
against
Personal Service Insurance Company, Appellant.
Freiberg, Peck & Kang, LLP (Yilo J. Kang of counsel), for appellant. The Rybak Firm, PLLC (Oleg Rybak of counsel), for respondent (no brief filed).
Appeal from an order of the Civil Court of the City of New York, Kings County (Cenceria P. Edwards, J.), entered March 13, 2019. The order, insofar as appealed from, denied defendant’s motion to dismiss the complaint.
ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s motion to dismiss the complaint is granted.
In this action by a provider to recover assigned first-party no-fault benefits, the affidavit of service alleges that the summons and complaint were served by mail pursuant to CPLR 312-a. However, plaintiff’s papers do not contain an acknowledgment of service. Defendant moved to dismiss the complaint on the ground that plaintiff had failed to obtain personal jurisdiction over defendant. Plaintiff cross-moved for summary judgment. Defendant appeals from so much of an order of the Civil Court entered March 13, 2019 as denied defendant’s motion to dismiss the complaint.
For the reasons stated in Longevity Med. Supply, Inc. v American Ind. Ins. Co. (69 Misc 3d 127[A], 2020 NY Slip Op 51118[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2020]), the order, insofar as appealed from, is reversed, and defendant’s motion to dismiss the complaint is granted.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Sanford Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2022 NY Slip Op 50576(U))
Sanford Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. |
2022 NY Slip Op 50576(U) [75 Misc 3d 138(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., MICHELLE WESTON, CHEREÉ A. BUGGS, JJ
2020-152 K C
against
State Farm Mutual Automobile Ins. Co., Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Rivkin Radler, LLP (Stuart M. Bodoff and Cheryl Korman of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Rosemarie Montalbano, J.), entered August 29, 2019. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order which granted defendant’s motion for summary judgment dismissing the complaint on the ground that plaintiff failed to appear for duly scheduled examinations under oath (EUOs), and denied plaintiff’s cross motion for summary judgment.
Plaintiff’s only contention with respect to defendant’s motion for summary judgment is that the affirmation submitted by defendant’s attorney, who was present in his office to conduct plaintiff’s EUOs on the scheduled dates, was insufficient to establish that plaintiff had failed to appear for the EUOs because it does not “conclusively prove that [counsel] was present at the scheduled start times of the EUOs.” We reject that argument. Counsel, a partner in the law firm representing defendant in this action, stated in his affirmation that the EUOs were scheduled to take place at 10:00 a.m. in his firm’s offices on December 14, 2017 and January 3, 2018; that he was “present in the office” on those days; that no one affiliated with plaintiff appeared for either scheduled EUO; and that if someone had appeared, he “would have conducted the EUO of the Plaintiff or assigned one of the other attorneys authorized to conduct EUOs to conduct the EUO of the Plaintiff.” Contrary to plaintiff’s argument, this affirmation was sufficient to demonstrate, prima facie, that plaintiff failed to appear for the EUOs (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]; Gentlecare Ambulatory Anesthesia Servs. v Geico Ins. Co., 57 Misc 3d 150[A], 2017 NY Slip Op 51518[U] [App Term, 2d Dept, 2d, 11th [*2]& 13th Jud Dists 2017]), and plaintiff failed to raise a triable issue of fact in response.
Accordingly, the order is affirmed.
ALIOTTA, P.J., WESTON and BUGGS, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Masigla v Nationwide Ins. (2022 NY Slip Op 50575(U))
Masigla v Nationwide Ins. |
2022 NY Slip Op 50575(U) [75 Misc 3d 138(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-109 K C
against
Nationwide Ins., Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Hollander Legal Group, P.C. (Allan S. Hollander of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered August 9, 2019. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order which granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
For the reasons stated in MSB Physical Therapy, P.C., as Assignee of Reid, Shamel W. v Nationwide Ins. (— Misc 3d —, 2022 NY Slip Op — [appeal No. 2019-1349 K C], decided herewith), the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Energy Chiropractic, P.C. v Nationwide Ins. (2022 NY Slip Op 50572(U))
Energy Chiropractic, P.C. v Nationwide Ins. |
2022 NY Slip Op 50572(U) [75 Misc 3d 137(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-78 K C
against
Nationwide Ins., Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Hollander Legal Group, P.C. (Allan S. Hollander of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered August 9, 2019. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order which granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
For the reasons stated in MSB Physical Therapy, P.C., as Assignee of Reid, Shamel W. v Nationwide Ins. (— Misc 3d —, 2022 NY Slip Op — [appeal No. 2019-1349 K C], decided herewith), the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Hands On Physical Therapy Care v Ameriprise Ins. (2022 NY Slip Op 50571(U))
Hands On Physical Therapy Care v Ameriprise Ins. |
2022 NY Slip Op 50571(U) [75 Misc 3d 137(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-75 K C
against
Ameriprise Insurance, Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Callinan & Smith LLP (Michael A. Callinan of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Rosemarie Montalbano, J.), entered August 27, 2019. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order granting defendant’s motion for summary judgment dismissing the complaint and denying plaintiff’s cross motion for summary judgment.
For the reasons stated in PFJ Med. Care, P.C., as Assignee of Simmond, Tylon B. v Nationwide Ins. (— Misc 3d —, 2022 NY Slip Op — [appeal No. 2020-74 K C], decided herewith), the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at PFJ Med. Care, P.C. v Nationwide Ins. (2022 NY Slip Op 50570(U))
PFJ Med. Care, P.C. v Nationwide Ins. |
2022 NY Slip Op 50570(U) [75 Misc 3d 137(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-74 K C
against
Nationwide Ins., Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Hollander Legal Group, P.C. (Allan S. Hollander of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered September 26, 2019. The order denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order denying plaintiff’s motion for summary judgment and granting defendant’s cross motion for summary judgment dismissing the complaint.
Contrary to plaintiff’s sole contention on appeal with respect to defendant’s cross motion for summary judgment dismissing the complaint, the affirmations submitted by defendant’s counsel, as well as the transcripts of the examinations under oath (EUOs), were sufficient to establish that plaintiff had failed to appear for the EUOs (see Pavlova v Nationwide Ins., 70 Misc 3d 144[A], 2021 NY Slip Op 50213[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]).
Accordingly, the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Columbus Imaging Ctr., LLC v Erie Ins. Co. of N.Y. (2022 NY Slip Op 50569(U))
Columbus Imaging Ctr., LLC v Erie Ins. Co. of N.Y. |
2022 NY Slip Op 50569(U) [75 Misc 3d 137(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-73 K C
against
Erie Insurance Company of New York, Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Law Office of Robyn M. Brilliant (Robyn M. Brilliant of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered September 27, 2019. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order granting defendant’s motion for summary judgment dismissing the complaint and denying plaintiff’s cross motion for summary judgment.
Contrary to plaintiff’s sole contention on appeal with respect to defendant’s motion for summary judgment, defendant did not need to demonstrate, as part of its prima facie case, that the first independent medical examination scheduling letter had been sent to plaintiff’s assignor within 15 days of defendant’s receipt of either the NF-2 or a claim received from another provider (see City Anesthesia Healthcare, P.C. v Erie Ins. Co. of NY, 70 Misc 3d 141[A], 2021 NY Slip Op 50135[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]; 11 NYCRR 65-3.5 [b]; Appendix 13; see also State Farm Mut. Auto. Ins. Co. v Surgicore of Jersey City, LLC, 195 AD3d 454 [2021]; Excel Prods., Inc. v Ameriprise Auto & Home, 71 Misc 3d 136[A], 2021 NY Slip Op 50435[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]).
Accordingly, the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Reported in New York Official Reports at Pain Med., PLLC v Tri State Consumer Ins. Co. (2022 NY Slip Op 50567(U))
Pain Med., PLLC v Tri State Consumer Ins. Co. |
2022 NY Slip Op 50567(U) [75 Misc 3d 137(A)] |
Decided on June 10, 2022 |
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 June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2019-1739 K C
against
Tri State Consumer Insurance Company, Appellant.
Law Office of Jason Tenenbaum, P.C. (Shaaker Bhuiyan of counsel), for appellant. Baker Sanders, LLC, for respondent (no brief filed).
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered September 27, 2019. The order, insofar as appealed from, denied the branches of defendant’s motion seeking summary judgment dismissing so much of the fifth and ninth causes of action as sought to recover in excess of the amounts permitted by the workers’ compensation fee schedule.
ORDERED that the appeal is dismissed.
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 the services rendered were not medically necessary. Defendant also sought summary judgment dismissing so much of the fifth and ninth causes of action as sought to recover in excess of the amounts permitted by the workers’ compensation fee schedule. Plaintiff opposed defendant’s motion. By order entered January 12, 2019, the Civil Court denied the branches of defendant’s motion seeking to dismiss so much of the fifth and ninth causes of action as sought to recover in excess of the amounts permitted by the workers’ compensation fee schedule but granted the branch of defendant’s motion seeking summary judgment dismissing the complaint on the ground that the services were not medically necessary.
As the order appealed from held that defendant was entitled to summary judgment dismissing all of the claims on the ground that all of the services were not medically necessary, defendant is not aggrieved by so much of the order as denied the branches of defendant’s motion seeking summary judgment dismissing so much of the fifth and ninth causes of action as sought to recover in excess of the amounts permitted by the workers’ compensation fee schedule (see CPLR 5511; Parochial Bus Sys. v Board of Educ. of City of NY, 60 NY2d 539, 545 [1983]; Botie [*2]v Town of Babylon, 71 Misc 3d 1298[A], 2021 NY Slip Op 50234[U] [App Term, 2d Dept, 9th & 10th Jud Dists 2021]).
Accordingly, the appeal is dismissed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022