Defendant appeals from an order of the Civil Court of the City of New York, Bronx County (Elizabeth A. Taylor, J.), entered July 8, 2014, which denied its motion for summary judgment dismissing the complaint.

Per Curiam.

Order (Elizabeth A. Taylor, J.), entered July 8, 2014, reversed, with $10 costs, and defendant’s motion for summary judgment dismissing the complaint is granted. The Clerk is directed to enter judgment accordingly.

The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the plaintiff-provider’s claim for first-party no-fault benefits by establishing that it timely and properly mailed the notices for independent medical examinations (IMEs) to plaintiff’s assignor, and that the assignor failed to appear (see American Tr. Ins. Co. v Lucas, 111 AD3d 423 [2013]; American Tr. Ins. Co. v Solorzano, 108 AD3d 449 [2013]). Contrary to plaintiff’s specific contention, defendant was entitled to request the IMEs prior to its receipt of plaintiff’s claim forms on January 10, 2011 (see 11 NYCRR 65-1.1; Steven Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 721 [2006]; Easy Care Acupuncture P.C. v Praetorian Ins. Co., 49 Misc 3d 137[A], 2015 NY Slip Op 51524[U][App Term, 1st Dept 2015]), and such request complied with the applicable procedures and time-frames set forth in the no-fault regulations (see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559, 560 [2011], lv denied 17 NY3d 705 [2011]; Inwood Hill Med., P.C. v General Assur. Co., 10 Misc 3d 18, 19-20 [2005]; cf. American Tr. Ins. Co. v Longevity Med. Supply, Inc., 131 AD3d 841 [2015]). Moreover, defendant submitted competent evidence of the assignor’s nonappearance in the form of the sworn affidavits of the scheduled examining chiropractor/acupuncturist and an employee of defendant’s third-party IME scheduler, setting forth sufficient facts to demonstrate the affiants’ personal knowledge of the assignor’s repeated failures to appear for the IMEs and the office practices and policies when an assignor fails to appear (see American Tr. Ins. Co. v Lucas, 111 AD3d at 424).

In opposition, plaintiff did not specifically deny the assignor’s nonappearance or [*2]otherwise raise a triable issue with respect thereto, or as to the mailing or reasonableness of the underlying notices (see Unitrin, 82 AD3d at 560). Accordingly, when the assignor failed to appear for the requested acupuncture IMEs, defendant had the right to deny all claims retroactively to the date of loss, regardless of whether the denials were timely issued (see American Tr. Ins. Co. v Lucas, 111 AD3d at 424), and even though defendant initially denied certain of the claims on different grounds (see Unitrin, 82 AD3d at 560).

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.

Decided on December 18, 2015

Plaintiff appeals from so much of an order of the Civil Court of the City of New York, New York County (David B. Cohen, J.), entered December 18, 2014, as granted defendant partial summary judgment dismissing plaintiff’s no-fault claims for services rendered April 9, 2009 through May 27, 2009, and June 25, 2009 through September 15, 2009.

Per Curiam.

Order (David B. Cohen, J.), entered December 18, 2014, insofar as appealed from, modified by reinstating plaintiff’s claim for first-party no-fault benefits billed under CPT code 99202; as modified, order affirmed, without costs.

The affidavits and other documentary evidence submitted by defendant established, prima facie, that it timely denied (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) plaintiff’s no-fault claims billed under CPT codes 97810, 97811, 97813 and 97814 for services rendered April 9, 2009 through May 27, 2009 and June 25, 2009 through September 15, 2009, on the ground that the amounts charged were in excess of the fees set forth in the applicable worker’s compensation fee schedule (see Akita Med. Acupuncture, P.C. v Clarendon Ins. Co., 41 Misc 3d 134[A], 2013 NY Slip Op 51860[U][App Term, 1st Dept 2013]; Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23 [App Term, 2d Dept 2009]). In opposition, plaintiff failed to raise a triable issue as to the efficacy of defendant’s mailing of the denial or the calculation of the fee pertaining to these claims.

However, triable issues remain as to whether defendant properly denied plaintiff’s claim for $61.43, billed under CPT code 99202 (initial evaluation), thus precluding summary judgment dismissing this claim (see Megacure Acupuncture, P.C. v Clarendon Natl. Ins. Co., 33 Misc 3d 141[A], 2011 NY Slip Op 52199[U][App Term, 2d, 11th & 13th Jud Dists 2011]; see also VS Care Acupuncture v State Farm Mut. Auto. Ins. Co., 46 Misc 3d 141[A], 2015 NY Slip Op 50164[U][App Term, 1st Dept 2015]).

Decision Date: December 18, 2015

Plaintiff appeals from an order the Civil Court of the City of New York, New York County (Tanya R. Kennedy, J.), entered February 3, 2015, which granted defendant’s motion for summary judgment dismissing the complaint.

Per Curiam.

Order (Tanya R. Kennedy, J.), entered February 3, 2015, affirmed, with $10 costs.

Defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the plaintiff-provider’s claim for first-party no-fault benefits by establishing that it properly mailed the notices for independent medical examinations (IMEs) to plaintiff’s assignor and her attorney, and that the assignor failed to appear (see American Tr. Ins. Co. v Lucas, 111 AD3d 423 [2013]; American Tr. Ins. Co. v Solorzano, 108 AD3d 449 [2013]). Contrary to plaintiff’s contention, defendant was entitled to request the IMEs prior to its receipt of plaintiff’s claim forms (see 11 NYCRR 65-1.1; Steven Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 721 [2006]; Easy Care Acupuncture P.C. v Praetorian Ins. Co., 49 Misc 3d 137[A], 2015 NY Slip Op 51524[U][App Term, 1st Dept 2015]; see also Inwood Hill Med., P.C. v General Assur. Co., 10 Misc 3d 18, 19-20 [2005]). Moreover, defendant submitted competent evidence of the assignor’s nonappearance in the form of the sworn affidavits of the scheduled examining chiropractor/acupuncturist and defendant’s third-party IME scheduler, setting forth facts sufficient to demonstrate the affiants’ personal knowledge of the assignor’s repeated failures to appear for the IMEs and the office practices and policies when an assignor fails to appear for a schedule IME (see American Tr. Ins. Co. v Lucas, 111 AD3d at 424; Harmonic Physical Therapy v Encompass Home and Auto Ins. Co. 47 Misc 3d 146[A], 2015 NY Slip Op 50733[U][App Term, 1st Dept 2015]).

In opposition, plaintiff did not specifically deny the assignor’s nonappearance or otherwise raise a triable issue with respect thereto, or as to the mailing or reasonableness of the underlying notices (see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559, 560 [2011], lv denied 17 NY3d 705 [2011]; see also Badio v Liberty Mut. Fire Ins. Co., 12 AD3d 229 [2004]). “Accordingly, when [plaintiff’s] assignor[] failed to appear for the [*2]requested medical exams, [defendant] had the right to deny all claims retroactively to the date of loss, regardless of whether the denials were timely issued” (American Tr. Ins. Co. v Lucas, 111 AD3d at 424), and even though defendant initially denied the claims on different grounds (see Unitrin, 82 AD3d at 560).

Plaintiff’s remaining contentions are unpreserved and/or without merit.

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.

[*1]

Bruno, Gerbino & Soriano, LLP, Melville (Mitchell L. Kaufman of counsel), for appellant.

The Geller Law Group, P.C., Brooklyn (Abraham J. Meir of counsel), for respondent.

Order, Supreme Court, New York County (Cynthia S. Kern, J.), entered on or about April 2, 2014, which denied the petition to vacate the award of the master arbitrator, and confirmed the award, unanimously affirmed, with costs.

Whether or not the fee-sharing arrangement at issue constitutes unprofessional conduct (see 8 NYCRR 29.1 [b] [4]), it does not constitute a defense to a no-fault action (compare State Farm Mut. Auto. Ins. Co. v Mallela, 4 NY3d 313, 319 [2005] [“insurance carriers may withhold payment for medical services provided by fraudulently incorporated enterprises to which patients have assigned their claims”]). It is solely a matter for the appropriate state licensing board (see e.g. Necula v Glass, 231 AD2d 457 [1st Dept 1996]; see also H & H Chiropractic Servs., P.C. v Metropolitan Prop. & Cas. Ins. Co., 47 Misc 3d 1075, 1078 [Civ Ct, Queens County 2015]). Concur—Mazzarelli, J.P., Richter, Manzanet-Daniels and Kapnick, JJ. [Prior Case History: 2014 NY Slip Op 30874(U).]

Plaintiff appeals from a judgment of the Civil Court of the City of New York, New York County (Robert R. Reed, J.), entered November 15, 2013, which, upon a prior order granting summary judgment, dismissed the complaint.

Per Curiam.

Judgment (Robert R. Reed, J.), entered November 15, 2013, reversed, with $30 costs, defendant’s motion denied, and the complaint reinstated.

Civil Court erred by treating defendant’s motion made pursuant to CPLR 3211(a)(1) and (7) as a motion for summary judgment without providing adequate notice to the parties (see CPLR 3211[c]; Mihlovan v Grozavu, 72 NY2d 506, 508 [1988]). The parties’ motion papers clearly indicated their intent to treat the motion as one made pursuant to CPLR 3211, and the case does not involve a purely legal question without any disputed issues of fact (see Brathwaite v Frankel, 98 AD3d 444, 445 [2012]; see also Drug Policy Alliance v The New York City Tax Commission, 131 AD3d 815 [2015]).

Treating the motion as one for dismissal pursuant to CPLR 3211, we conclude that it should have been denied. Accepting plaintiff’s allegations as true, and according them the benefit of every possible favorable inference, as we must in the context of a motion to dismiss the pleadings (Leon v Martinez, 84 NY2d 83, 87-88 [1994]), we find the complaint sufficient to state a cause of action for recovery of first-party no-fault benefits pursuant to an automobile insurance policy issued by defendant (see Genovese v State Farm Mut. Auto. Ins. Co., 106 AD3d 866, 868 [2013]; Innovative MR Imaging, P.C. v New York Cent. Mut. Fire Ins. Co., 38 Misc 3d 147[A], 2013 NY Slip Op 50359[U][App Term, 1st Dept 2013]).

Contrary to defendant’s contention, the affidavits submitted in support of its defense – that plaintiff is not entitled to no-fault coverage because it breached a condition precedent under the policy by failing to appear for examinations under oath (EUOs) (see 11 NYCRR 65-1.1) – do not “‘establish conclusively that [plaintiff] has no [claim or] cause of action'” (Lawrence v Graubard Miller, 11 NY3d 588, 595 [2008], quoting Rovello v Orofino Realty Co., 40 NY2d 633, 636 [*2][1976]), and are “not properly considered on a motion to dismiss pursuant to CPLR 3211 (a)(7)” (GEM Holdco, LLC v Changing World Tech., L.P., 127 AD3d 598, 599 [2015]; see Lee v Dow Jones & Co., Inc., 121 AD3d 548 [2014]; Sokol v Leader, 74 AD3d 1180 [2010]). Nor (as defendant effectively concedes), were the affidavits “essentially undeniable” so as to qualify as documentary evidence (see CPLR 3211[a][1]) that conclusively establishes its defense or definitively refutes any claim that plaintiff may have to recover under the policy (see Mason v First Cent. Natl. Life Ins. Co. of NY, 86 AD3d 854, 855 [2011]).

Defendant’s remaining contentions are unpreserved and/or without merit.

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.

Decided on November 12, 2015

Decided on November 12, 2015

Decided on October 27, 2015

Defendant appeals from an order the Civil Court of the City of New York, New York County (Jose A. Padilla, Jr., J.), entered February 11, 2015, which denied its motion for summary judgment dismissing the complaint.

Per Curiam.

Order (Jose A. Padilla, Jr., J.), entered February 11, 2015, reversed, with $10 costs, motion granted and complaint dismissed. The Clerk is directed to enter judgment accordingly.

The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the action for first-party no-fault benefits by establishing that it properly mailed the notices for chiropractic/acupuncture independent medical examinations (IMEs) to plaintiff’s assignor and that the assignor failed to appear (see American Tr. Ins. Co. v Lucas, 111 AD3d 423 [2013]; American Tr. Ins. Co. v Solorzano, 108 AD3d 449 [2013]). Contrary to plaintiff’s specific contention, defendant was entitled to request the IMEs prior to its receipt of plaintiff’s claim forms (see 11 NYCRR 65-1.1 [an insurer has a right to request IMEs “when, and as often as [it] may reasonably require”]; Steven Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 721 [2006] [an insurer is entitled to request IMEs “before . . . or after the claim form is submitted” (emphasis supplied)]; see also Inwood Hill Med., P.C. v General Assur. Co., 10 Misc 3d 18, 19-20 [2005]). Moreover, defendant submitted competent evidence of the assignor’s nonappearance, in the form of the sworn affidavits of the scheduled examining chiropractors/ acupuncturists and an employee of defendant’s third-party IME scheduler, setting forth facts sufficient to demonstrate the affiants’ personal knowledge of the assignor’s repeated failures to appear for the IMEs and the office practices and policies when an assignor fails to appear for a scheduled IME (see American Tr. Ins. Co. v Lucas, 111 AD3d at 424).

In opposition to defendant’s prima facie showing, plaintiff did not specifically deny the assignor’s nonappearance or otherwise raise a triable issue with respect thereto, or as to the mailing or reasonableness of the underlying notices (see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559, 560 [2011], lv denied 17 NY3d 705 [2011]; see also Badio v Liberty Mut. Fire Ins. Co., 12 AD3d 229 [2004]; Abuhamra v New York Mut. [*2]Underwriters, 170 AD2d 1003 [1991]).

In view of our determination, we reach no other issue.

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.