Lenex Servs., Inc. v Travelers Ins. (2019 NY Slip Op 51811(U))

Reported in New York Official Reports at Lenex Servs., Inc. v Travelers Ins. (2019 NY Slip Op 51811(U))

Lenex Servs., Inc. v Travelers Ins. (2019 NY Slip Op 51811(U)) [*1]
Lenex Servs., Inc. v Travelers Ins.
2019 NY Slip Op 51811(U) [65 Misc 3d 148(A)]
Decided on November 8, 2019
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This opinion is uncorrected and will not be published in the printed Official Reports.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 November 8, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-870 K C
Lenex Services, Inc., as Assignee of Dekenya Hanter and Ingrid Montgomery, Appellant,

against

Travelers Insurance, Respondent.

Zara Javakov, P.C. (Zara Javakov of counsel), for appellant. Law Office of Aloy O. Ibuzor (William P. Kleen of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Harriet L. Thompson, J.), entered October 4, 2017. 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 of the Civil Court which denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint on the ground that plaintiff had failed to appear for duly scheduled examinations under oath.

For the reasons stated in Allay Med. Servs., P.C., as Assignee of Harrison, Henry v Travelers Ins. Co. (___ Misc 3d ___, 2019 NY Slip Op _____ [appeal No. 2017-2383 K C], decided herewith, the order is affirmed.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 08, 2019
Lvov Acupuncture, P.C. v Hereford Ins. Co. (2019 NY Slip Op 51809(U))

Reported in New York Official Reports at Lvov Acupuncture, P.C. v Hereford Ins. Co. (2019 NY Slip Op 51809(U))

Lvov Acupuncture, P.C. v Hereford Ins. Co. (2019 NY Slip Op 51809(U)) [*1]
Lvov Acupuncture, P.C. v Hereford Ins. Co.
2019 NY Slip Op 51809(U) [65 Misc 3d 147(A)]
Decided on November 8, 2019
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 November 8, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-732 K C
Lvov Acupuncture, P.C., as Assignee of Iesha George, Appellant,

against

Hereford Insurance Co., Respondent.

Kopelevich & Feldsherova, P.C. (David Landfair of counsel), for appellant. Goldberg, Miller & Rubin (Matthew Lavoie of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Louis L. Nock, J.), entered December 20, 2017. 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 on the ground that plaintiff had failed to appear for duly scheduled examinations under oath.

For the reasons stated in Allay Med. Servs., P.C., as Assignee of Harrison, Henry v Travelers Ins. Co. (___ Misc 3d ___, 2019 NY Slip Op _____ [appeal No. 2017-2383 K C], decided herewith), the order is affirmed.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 08, 2019
Diagnostic Radiographic Imaging, P.C. v GEICO Ins. Co. (2019 NY Slip Op 51807(U))

Reported in New York Official Reports at Diagnostic Radiographic Imaging, P.C. v GEICO Ins. Co. (2019 NY Slip Op 51807(U))

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

Diagnostic Radiographic Imaging, P.C., as Assignee of Bonita Brown, Appellant,

against

GEICO Ins. Co., Respondent.

Zara Javakov, P.C. (Zara Javakov of counsel), for appellant. Law Office of Goldstein & Flecker (Lawrence J. Chanice of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Richard J. Montelione, J.), entered November 2, 2017. The order granted defendant’s motion to dismiss the complaint pursuant to CPLR 3216.

ORDERED that the order is affirmed, with $25 costs.

Plaintiff commenced this action to recover assigned first-party no-fault benefits in 2010. Over five years later, in August 2016, defendant served a 90-day written demand pursuant to CPLR 3216 (b) (3). On or about December 16, 2016, defendant moved to dismiss the complaint, pursuant to CPLR 3216, as defendant had not been served with a notice of trial.

Once a 90-day demand is received by a plaintiff in a Civil Court action, the plaintiff must either comply with the demand by filing a notice of trial within 90 days (see CPLR 3216 [c]), or move before the default date either to vacate the demand or to extend the 90-day period pursuant to CPLR 2004 (see Felix v County of Nassau, 52 AD3d 653 [2008]; South Nassau Orthopedic Surgery & Sports Medicine, P.C. v Geico Ins. Co., 47 Misc 3d 142[A], 2015 NY Slip Op 50674[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]). Since plaintiff failed to do either of these, it was required, in opposition to defendant’s motion to dismiss, to establish a [*2]justifiable excuse for its delay in properly responding to the 90-day demand, and the existence of a meritorious cause of action (see Felix, 52 AD3d 653; South Nassau Orthopedic Surgery & Sports Medicine, P.C., 47 Misc 3d 142[A], 2015 NY Slip Op 50674[U]).

Defendant’s motion was properly granted as, “in opposition to defendant’s motion to dismiss the complaint, plaintiff made no attempt to demonstrate the existence of an excuse, justifiable or otherwise, for plaintiff’s failure to comply with the 90-day notice” (South Nassau Orthopedic Surgery & Sports Medicine, P.C., 47 Misc 3d 142[A], 2015 NY Slip Op 50674[U], *1; see also Baczkowski v Collins Constr. Co., 89 NY2d 499 [1997]; Schottenstein Pain & Neuro, PLLC v GEICO Ins. Co., 62 Misc 3d 141[A], 2019 NY Slip Op 50085[U] [App Term, 2d Dept, 9th & 10th Jud Dists 2019]).

Accordingly, the order is affirmed.

WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 08, 2019
Allay Med. Servs., P.C. v Travelers Ins. Co. (2019 NY Slip Op 51806(U))

Reported in New York Official Reports at Allay Med. Servs., P.C. v Travelers Ins. Co. (2019 NY Slip Op 51806(U))

Allay Med. Servs., P.C. v Travelers Ins. Co. (2019 NY Slip Op 51806(U)) [*1]
Allay Med. Servs., P.C. v Travelers Ins. Co.
2019 NY Slip Op 51806(U) [65 Misc 3d 147(A)]
Decided on November 8, 2019
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 November 8, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2017-2383 K C
Allay Medical Services, P.C., as Assignee of Harrison, Henry, Appellant,

against

Travelers Insurance Company, Respondent.

The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Law Office of Aloy O. Ibuzor (Allison H. Farkas of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Louis L. Nock, J.), entered September 12, 2017. 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 of the Civil Court which granted defendant’s motion for summary judgment dismissing the complaint on the ground that plaintiff’s assignor had failed to appear for duly scheduled examinations under oath (EUOs), and denied plaintiff’s cross motion for summary judgment.

Contrary to plaintiff’s contentions on appeal, defendant established that the EUO scheduling letters and denial of claim form had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) and that plaintiff had failed to appear for the duly scheduled EUOs (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]).

Plaintiff’s remaining arguments are not properly before this court as 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]; Mind & Body Acupuncture, P.C. v Elrac, Inc., 48 Misc 3d 139[A], 2015 NY Slip Op 51219[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]).

Accordingly, the order is affirmed.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 08, 2019
Bed Stuy Med., P.C. v Travelers Ins. (2019 NY Slip Op 51805(U))

Reported in New York Official Reports at Bed Stuy Med., P.C. v Travelers Ins. (2019 NY Slip Op 51805(U))

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

Bed Stuy Medical, P.C., as Assignee of Valdez Vallon, and Bed Stuy Physical Therapy, P.C., as Assignee of Valdez Vallon, Respondents,

against

Travelers Insurance, Appellant.

Law Offices of Aloy O. Ibuzor (Michael L. Rappaport of counsel), for appellant. Zara Javakov, P.C. (Zara Javakov of counsel), for respondents (no brief filed).

Appeal from an order of the Civil Court of the City of New York, Kings County (Harriet L. Thompson, J.), entered October 3, 2017. The order denied defendant’s motion for summary judgment dismissing the complaint and made implicit CPLR 3212 (g) findings in plaintiff’s favor.

ORDERED that the order is reversed, with $30 costs, and defendant’s motion for summary judgment dismissing the complaint is granted.

Plaintiffs, Bed Stuy Medical, P.C. and Bed Stuy Physical Therapy, P.C., commenced this action to recover first-party no-fault benefits for services they had provided to their assignor, Valdez Vallon, who had allegedly sustained injuries in a motor vehicle accident which had occurred on March 15, 2013. Defendant moved for summary judgment dismissing the complaint on the ground that, in a prior action entitled “Yevgeniy Margulis, Ph.D., Bed Stuy Physical Therapy, P.C., Bed Stuy Medical, P.C. a/a/o Constantine McLaughlin, Valdez Vallon against Travelers Insurance,” the Civil Court (Theresa M. Ciccotto, J.), by order entered January 28, 2016, had granted defendant’s motion for summary judgment dismissing the same claims related [*2]to the same accident and assignor, Valdez Vallon, as the claims at issue herein.[FN1] Defendant’s motion for summary judgment in the prior action had been unopposed, and plaintiffs never moved to vacate their default in opposing the motion. Thus, defendant asserted, plaintiffs’ present action is barred by the doctrine of res judicata. Defendant appeals from an order of the Civil Court (Harriet L. Thompson, J.) entered October 3, 2017 denying defendant’s motion for summary judgment dismissing this action and making implicit CPLR 3212 (g) findings in plaintiff’s favor.

“Under the doctrine of res judicata, a final adjudication of a claim on the merits precludes relitigation of that claim and all claims arising out of the same transaction or series of transactions by a party or those in privity with a party” (Ciraldo v JP Morgan Chase Bank, N.A., 140 AD3d 912, 913-914 [2016]; see Matter of Hunter, 4 NY3d 260, 269 [2005]; Schuylkill Fuel Corp. v Nieberg Realty Corp., 250 NY 304, 306-307 [1929]). The doctrine of res judicata is applicable to a judgment that has not been vacated (see Lazides v P & G Enters., 58 AD3d 607 [2009]; Matter of Eagle Ins. Co. v Facey, 272 AD2d 399 [2000]).

In support of the motion at issue, defendant submitted the January 28, 2016 order of the Civil Court and defendant’s moving papers in the prior action, which included the complaint, supporting affidavits and the claim forms involved therein. Upon a review of the record, we find that defendant’s moving papers established that the causes of action asserted herein are identical to those which were asserted in the prior action, which action was decided by the January 28, 2016 order of the Civil Court granting defendant’s motion for summary judgment dismissing those claims. In view of the foregoing, plaintiffs were precluded, under the doctrine of res judicata, from asserting the same causes of action in this case (see Matter of Hodes v Axelrod, 70 NY2d 364, 372 [1987]; see also Matter of Hunter, 4 NY3d 260; Lighthouse 925 Hempstead, LLC v Citibank, N.A., 66 AD3d 846, 847 [2009]; Matter of ADC Contr. & Constr., Inc. v Town of Southampton, 50 AD3d 1025 [2008]). Consequently, defendant established its entitlement to summary judgment.

Accordingly, the order is reversed and defendant’s motion for summary judgment dismissing the complaint is granted.

PESCE, P.J., WESTON and ALIOTTA, JJ., concur.

ENTER:

Paul Kenny

Chief Clerk

Decision Date: November 08, 2019

Footnotes

Footnote 1:The claim by Yevgeniy Margulis, Ph.D., as assignee of Constantine McLaughlin, was previously settled by stipulation dated April 2, 2014.

BQE Acupuncture, P.C. v GEICO Ins. Co. (2019 NY Slip Op 51803(U))

Reported in New York Official Reports at BQE Acupuncture, P.C. v GEICO Ins. Co. (2019 NY Slip Op 51803(U))

BQE Acupuncture, P.C. v GEICO Ins. Co. (2019 NY Slip Op 51803(U)) [*1]
BQE Acupuncture, P.C. v GEICO Ins. Co.
2019 NY Slip Op 51803(U) [65 Misc 3d 147(A)]
Decided on November 1, 2019
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 November 1, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-1631 K C
BQE Acupuncture, P.C., as Assignee of Hart Peter, Respondent,

against

GEICO Ins. Co., Appellant.

Law Office of Goldstein & Flecker (Lawrence J. Chanice 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 (Lorna J. McAllister, J.), entered June 11, 2018. The order, insofar as appealed from and as limited by the brief, denied defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s cross 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, as limited by the brief, from so much of an order of the Civil Court as denied defendant’s cross motion for summary judgment dismissing the complaint.

For the reasons stated in Acupuncture Now, P.C., as Assignee of Lozano, Cleotilde v Global Liberty Ins. (___ Misc 3d ___, 2019 NY Slip Op _____ [appeal No. 2018-962 K C], decided herewith), the order, insofar as appealed from, is reversed and defendant’s cross motion for summary judgment dismissing the complaint is granted.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 01, 2019
Sovera Med. Supply Corp. v 21st Century Ins. Co. (2019 NY Slip Op 51802(U))

Reported in New York Official Reports at Sovera Med. Supply Corp. v 21st Century Ins. Co. (2019 NY Slip Op 51802(U))

Sovera Med. Supply Corp. v 21st Century Ins. Co. (2019 NY Slip Op 51802(U)) [*1]
Sovera Med. Supply Corp. v 21st Century Ins. Co.
2019 NY Slip Op 51802(U) [65 Misc 3d 147(A)]
Decided on November 1, 2019
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 November 1, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-1317 K C
Sovera Medical Supply Corp., as Assignee of Zunilda Garcia, Appellant,

against

21st Century Insurance Company, Respondent.

The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Law Offices of Buratti, Rothenberg & Burns (Rachel L. Hollander of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Richard J. Montelione, J.), entered March 27, 2018. 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, defendant moved for summary judgment dismissing the complaint on the ground, among others, that there was a lack of medical necessity for the supplies in question, and plaintiff cross-moved for summary judgment. The Civil Court granted defendant’s motion and denied plaintiff’s cross motion.

Contrary to plaintiff’s contention, the peer review report submitted by defendant sufficiently set forth a factual basis and medical rationale for the peer reviewer’s determination that there was a lack of medical necessity for the supplies at issue. In opposition to defendant’s motion, plaintiff submitted an affidavit from a doctor which failed to meaningfully refer to, let alone sufficiently rebut, the conclusions set forth in the peer review report (see Pan Chiropractic, [*2]P.C. v Mercury Ins. Co., 24 Misc 3d 136[A], 2009 NY Slip Op 51495[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009]).

In light of the foregoing, we reach no other issue.

Accordingly, the order is affirmed.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 01, 2019
Y.A.M. Med. Supply, Inc. v Global Liberty Ins. Co. of NY (2019 NY Slip Op 51801(U))

Reported in New York Official Reports at Y.A.M. Med. Supply, Inc. v Global Liberty Ins. Co. of NY (2019 NY Slip Op 51801(U))

Y.A.M. Med. Supply, Inc. v Global Liberty Ins. Co. of NY (2019 NY Slip Op 51801(U)) [*1]
Y.A.M. Med. Supply, Inc. v Global Liberty Ins. Co. of NY
2019 NY Slip Op 51801(U) [65 Misc 3d 147(A)]
Decided on November 1, 2019
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 November 1, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-1176 K C
Y.A.M. Medical Supply, Inc., as Assignee of Kallamni Hicham, Respondent,

against

Global Liberty Ins. Co. of NY, Appellant.

Law Office of Jason Tenenbaum, P.C. (Jason Tenenbaum of counsel), for appellant. Gary Tsirelman, P.C. (Douglas Mace of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered May 17, 2018. The order, insofar as appealed from as limited by the brief, denied defendant’s cross motion seeking to hold the action in abeyance pending a determination by the Workers’ Compensation Board of the parties’ rights under the Workers’ Compensation Law.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, defendant cross-moved to hold the action in abeyance pending an application to the Workers’ Compensation Board to determine the parties’ rights under the Workers’ Compensation Law based upon plaintiff’s assignor’s alleged eligibility for workers’ compensation benefits. By order entered May 17, 2018, insofar as is relevant, the Civil Court denied defendant’s cross motion. Defendant appeals.

The defense that the assignor is eligible for workers’ compensation benefits is subject to preclusion (see Westchester Med. Ctr. v Lincoln Gen. Ins. Co., 60 AD3d 1045 [2009]). As defendant failed to demonstrate that it had timely denied plaintiff’s claims on the ground that the [*2]assignor was injured in the course of his employment (see 11 NYCRR 65-3.5 [a]; Presbyterian Hosp. in City of NY v Maryland Cas. Co., 90 NY2d 274, 282 [1997]), defendant’s cross motion was properly denied.

Accordingly, the order, insofar as appealed from, is affirmed.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 01, 2019
GC Chiropractic, P.C. v Integon Natl. Ins. Co. (2019 NY Slip Op 51800(U))

Reported in New York Official Reports at GC Chiropractic, P.C. v Integon Natl. Ins. Co. (2019 NY Slip Op 51800(U))

GC Chiropractic, P.C. v Integon Natl. Ins. Co. (2019 NY Slip Op 51800(U)) [*1]
GC Chiropractic, P.C. v Integon Natl. Ins. Co.
2019 NY Slip Op 51800(U) [65 Misc 3d 146(A)]
Decided on November 1, 2019
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 November 1, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-1173 K C
GC Chiropractic, P.C., as Assignee of Edith Carver, Appellant,

against

Integon National Ins. Co., Respondent.

Gary Tsirelman, P.C. (Devon Riley Christian of counsel), for appellant. Law Offices of Moira Doherty, P.C., for respondent (no brief filed).

Appeal from an order of the Civil Court of the City of New York, Kings County (Rosemarie Montalbano, J.), entered May 7, 2018. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion to compel discovery.

ORDERED that the order is reversed, with $30 costs, defendant’s motion for summary judgment dismissing the complaint is denied and plaintiff’s cross motion to compel discovery is granted.

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 of lack of medical necessity. Plaintiff opposed the motion on the ground that defendant had failed to respond to discovery demands and that defendant’s responses were necessary to oppose defendant’s motion (see CPLR 3212 [f]). Plaintiff also cross-moved to compel defendant to provide the requested discovery (see CPLR 3124). The Civil Court granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion seeking to compel discovery.

In opposition to defendant’s motion, and in support of its cross motion to compel [*2]discovery, plaintiff demonstrated that it had requested from defendant, but had not received in time to oppose defendant’s motion (see CPLR 3212 [f]), the medical records relied upon by defendant’s peer reviewer. In light of the foregoing, defendant is not entitled to summary judgment dismissing the complaint (see IDF Diagnostic Med., P.C. v New York Cent. Mut. Fire Ins. Co., 48 Misc 3d 138[A], 2015 NY Slip Op 51213[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]; see also Alrof, Inc. v Progressive Ins. Co., 34 Misc 3d 29 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]).

Accordingly, the order is reversed, defendant’s motion for summary judgment dismissing the complaint is denied and plaintiff’s cross motion to compel discovery is granted.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 01, 2019
Psychology YME, P.C. v Travelers Ins. (2019 NY Slip Op 51798(U))

Reported in New York Official Reports at Psychology YME, P.C. v Travelers Ins. (2019 NY Slip Op 51798(U))

Psychology YME, P.C. v Travelers Ins. (2019 NY Slip Op 51798(U)) [*1]
Psychology YME, P.C. v Travelers Ins.
2019 NY Slip Op 51798(U) [65 Misc 3d 146(A)]
Decided on November 1, 2019
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 November 1, 2019

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-1073 K C
Psychology YME, P.C., as Assignee of Josie Gonzalez, Respondent,

against

Travelers Insurance, Appellant.

Law Office of Aloy O. Ibuzor (Gregory W. Broido 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 (Robin S. Garson, J.), entered March 27, 2018. The order denied defendant’s motion for summary judgment dismissing the complaint and granted plaintiff’s cross motion for summary judgment.

ORDERED that the order is reversed, with $30 costs, defendant’s motion for summary judgment dismissing the complaint is granted and plaintiff’s cross motion for summary judgment is denied.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court denying defendant’s motion which had sought summary judgment dismissing the complaint based on plaintiff’s failure to provide requested verification within 120 days of the initial verification request (see 11 NYCRR 65-3.5 [o]), and granting plaintiff’s cross motion for summary judgment.

Defendant’s proof was sufficient to demonstrate prima facie that it had timely mailed initial and follow-up verification requests (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]); that it had not received the requested verification; and that it had timely denied the claim on that ground. In opposition, plaintiff failed to raised a [*2]triable issue of fact.

Accordingly, the order is reversed, defendant’s motion for summary judgment dismissing the complaint is granted and plaintiff’s cross motion for summary judgment is denied.

PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 01, 2019