Reported in New York Official Reports at Gentlecare Ambulatory Anesthesia Servs. v American Ind. Ins. Co. (2019 NY Slip Op 50635(U))
| Gentlecare Ambulatory Anesthesia Servs. v American Ind. Ins. Co. |
| 2019 NY Slip Op 50635(U) [63 Misc 3d 144(A)] |
| Decided on April 26, 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| This opinion is uncorrected and will not be published in the printed Official Reports.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 April 26, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., MICHELLE WESTON, THOMAS P. ALIOTTA, JJ
2017-969 K C
against
American Independent Ins. Co., Appellant.
Freiberg, Peck & Kang, LLP (Yilo J. Kang of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Mary V. Rosado, J.), entered June 6, 2017. The order, insofar as appealed from, denied defendant’s motion to dismiss the complaint pursuant to CPLR 3211 (a) (8).
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, defendant appeals from so much of an order of the Civil Court as denied defendant’s motion which sought to dismiss the complaint pursuant to CPLR 3211 (a) (8) on the ground that the Civil Court lacked personal jurisdiction over defendant.
For the reasons stated in Pavlova v American Ind. Ins. Co. (60 Misc 3d 128[A], 2018 NY Slip Op 50943[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2018]), the order, insofar as appealed from, is reversed, and defendant’s motion to dismiss the complaint is granted (see also Matter of Government Empls. Ins. Co. v Basedow, 28 AD3d 766 [2006]; Matter of Eagle Ins. Co. v Gutierrez-Guzman, 21 AD3d 489 [2005]).
PESCE, P.J., WESTON and ALIOTTA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 26, 2019
Reported in New York Official Reports at Gentlecare Ambulatory Anesthesia Servs. v American Ind. Ins. Co. (2019 NY Slip Op 50634(U))
| Gentlecare Ambulatory Anesthesia Servs. v American Ind. Ins. Co. |
| 2019 NY Slip Op 50634(U) [63 Misc 3d 144(A)] |
| Decided on April 26, 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 April 26, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., MICHELLE WESTON, THOMAS P. ALIOTTA, JJ
2017-968 K C
against
American Independent Ins. Co., Appellant.
Freiberg, Peck & Kang, LLP (Yilo J. Kang of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell and Karina Barska 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 April 26, 2017. The order, insofar as appealed from, denied defendant’s motion to dismiss the complaint pursuant to CPLR 3211 (a) (8).
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, defendant appeals from so much of an order of the Civil Court as denied defendant’s motion which sought to dismiss the complaint pursuant to CPLR 3211 (a) (8) on the ground that the Civil Court lacked personal jurisdiction over defendant.
For the reasons stated in Pavlova v American Ind. Ins. Co. (60 Misc 3d 128[A], 2018 NY Slip Op 50943[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2018]), the order, insofar as appealed from, is reversed, and defendant’s motion to dismiss the complaint is granted (see also Matter of Government Empls. Ins. Co. v Basedow, 28 AD3d 766 [2006]; Matter of Eagle Ins. Co. v Gutierrez-Guzman, 21 AD3d 489 [2005]).
PESCE, P.J., WESTON and ALIOTTA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 26, 2019
Reported in New York Official Reports at Gentlecare Ambulatory Anesthesia Servs. v American Ind. Ins. Co. (2019 NY Slip Op 50633(U))
| Gentlecare Ambulatory Anesthesia Servs. v American Ind. Ins. Co. |
| 2019 NY Slip Op 50633(U) [63 Misc 3d 144(A)] |
| Decided on April 26, 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 April 26, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., MICHELLE WESTON, THOMAS P. ALIOTTA, JJ
2017-967 K C
against
American Independent Ins. Co., Appellant.
Freiberg, Peck & Kang, LLP (Yilo J. Kang of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell and Karina Barska 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 April 26, 2017. The order, insofar as appealed from, denied defendant’s motion to dismiss the complaint pursuant to CPLR 3211 (a) (8).
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, defendant appeals from so much of an order of the Civil Court as denied defendant’s motion which sought to dismiss the complaint pursuant to CPLR 3211 (a) (8) on the ground that the Civil Court lacked personal jurisdiction over defendant.
For the reasons stated in Pavlova v American Ind. Ins. Co. (60 Misc 3d 128[A], 2018 NY Slip Op 50943[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2018]), the order, insofar as appealed from, is reversed, and defendant’s motion to dismiss the complaint is granted (see also Matter of Government Empls. Ins. Co. v Basedow, 28 AD3d 766 [2006]; Matter of Eagle Ins. Co. v Gutierrez-Guzman, 21 AD3d 489 [2005]).
PESCE, P.J., WESTON and ALIOTTA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 26, 2019
Reported in New York Official Reports at Performance Plus Med., P.C. v American Ind. Ins. Co. (2019 NY Slip Op 50632(U))
| Performance Plus Med., P.C. v American Ind. Ins. Co. |
| 2019 NY Slip Op 50632(U) [63 Misc 3d 143(A)] |
| Decided on April 26, 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 April 26, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., MICHELLE WESTON, THOMAS P. ALIOTTA, JJ
2017-242 K C
against
American Independent Ins. Co., Appellant.
Freiberg, Peck & Kang, LLP (Yilo J. Kang of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell and Karina Barska 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 January 6, 2017. The order, insofar as appealed from, denied defendant’s motion to dismiss the complaint pursuant to CPLR 3211 (a) (8).
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, defendant appeals from so much of an order of the Civil Court as denied defendant’s motion which sought to dismiss the complaint pursuant to CPLR 3211 (a) (8) on the ground that the Civil Court lacked personal jurisdiction over defendant.
For the reasons stated in Pavlova v American Ind. Ins. Co. (60 Misc 3d 128[A], 2018 NY Slip Op 50943[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2018]), the order, insofar as appealed from, is reversed, and defendant’s motion to dismiss the complaint is granted (see also Matter of Government Empls. Ins. Co. v Basedow, 28 AD3d 766 [2006]; Matter of Eagle Ins. Co. v Gutierrez-Guzman, 21 AD3d 489 [2005]).
PESCE, P.J., WESTON and ALIOTTA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 26, 2019
Reported in New York Official Reports at Sure Way NY, Inc. v Travelers Ins. Co. (2019 NY Slip Op 50601(U))
| Sure Way NY, Inc. v Travelers Ins. Co. |
| 2019 NY Slip Op 50601(U) [63 Misc 3d 142(A)] |
| Decided on April 15, 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 April 15, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHELLE WESTON, J.P., THOMAS P. ALIOTTA, DAVID ELLIOT, JJ
2017-9 K C
against
Travelers Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for appellant. Law Offices of Aloy O. Ibuzor (Duane Frankson 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 May 17, 2016. 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 that plaintiff’s assignor does not qualify as an eligible injured person, as the assignor was not a “family member” of the insured as defined in the Florida insurance policy at issue. Plaintiff cross-moved for summary judgment, asserting that, at a minimum, it had established its prima facie case. By order entered May 17, 2016, the Civil Court granted defendant’s motion and denied plaintiff’s cross motion.
Upon the record presented, we find that defendant sufficiently established that plaintiff’s assignor did not reside in the household of the Florida policyholder, but, rather, in Brooklyn, and thus was not a “family member” of the insured as defined by the insurance policy at issue. In opposition, plaintiff failed to raise a triable issue of fact (see Zuckerman v City of New York, 49 NY2d 557 [1980]). Consequently, defendant’s motion for summary judgment dismissing the [*2]complaint was properly granted.
Accordingly, the order is affirmed.
WESTON, J.P., ALIOTTA and ELLIOT, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 15, 2019
Reported in New York Official Reports at Sure Way NY, Inc. v Travelers Ins. Co. (2019 NY Slip Op 50600(U))
| Sure Way NY, Inc. v Travelers Ins. Co. |
| 2019 NY Slip Op 50600(U) [63 Misc 3d 141(A)] |
| Decided on April 15, 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 April 15, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., MICHELLE WESTON, BERNICE D. SIEGAL, JJ
2016-2079 K C
against
Travelers Insurance Company, Appellant.
The Rybak Firm, PLLC (Duane Frankson of counsel), for appellant. Law Offices of Aloy O. Ibuzor (Damin J. Toell and Karina Barska of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Katherine A. Levine, J.), entered April 20, 2016. The order denied defendant’s motion for summary judgment dismissing the complaint.
ORDERED that the order is reversed, without 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 an order of the Civil Court which denied defendant’s motion for summary judgment dismissing the complaint.
For the reasons stated in Sure Way, Inc., as Assignee of Dixin, Marla v Travelers Ins. Co. (__ Misc 3d ___, 2019 NY Slip Op ______ [appeal No. 2017-9 K C], decided herewith), the order is reversed and defendant’s motion for summary judgment dismissing the complaint is granted.
The decision and order of this court dated July 13, 2018 (60 Misc 3d 139[A], 2018 NY Slip Op 51130[U]) is hereby recalled and vacated (see motion decided simultaneously herewith).
PESCE, P.J., WESTON and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 15, 2019
Reported in New York Official Reports at CPM Med Supply, Inc. v State Farm Fire & Cas. Ins. Co. (2019 NY Slip Op 50576(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
State Farm Fire and Casualty Insurance Company, Respondent.
Fuld & Karp, P.C. (David Karp of counsel), for appellant. Richard T. Lau & Associates (Linda Filosa and Arthur Kontaxis 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 August 31, 2016. The order granted defendant’s motion for summary judgment dismissing the complaint as premature.
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 as premature, as plaintiff had failed to provide verification which defendant had requested.
Contrary to plaintiff’s argument, it was required to respond to defendant’s verification requests. As plaintiff did not respond to defendant’s verification requests with respect to plaintiff’s claim for the sum of $1,989.85, plaintiff failed to demonstrate a basis to disturb so much of the order as dismissed the complaint insofar as it sought to recover upon the $1,989.85 claim.
While plaintiff did respond in writing to defendant’s verification requests pertaining to the claim for $1,785, plaintiff neither provided the invoices requested by defendant nor stated that it was not in possession or control of those invoices. Rather, plaintiff merely set forth its opinion that the items requested were “not needed,” based upon its own interpretation of how the rate of reimbursement should be calculated. This is not a “reasonable justification for the failure to comply” with a verification request (11 NYCRR 65-3.8 [b] [3]), or a sufficient response (see Village Med. Supply, Inc. v Travelers Prop. Cas. Ins. Co., 61 Misc 3d 126[A], 2018 NY Slip Op 51311[U] [App Term, 1st Dept 2018]; D & R Med. Supply v American Tr. Ins. Co., 32 Misc 3d 144[A], 2011 NY Slip Op 51727[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]; Urban Radiology, P.C. v Tri-State Consumer Ins. Co., 27 Misc 3d 140[A], 2010 NY Slip Op 50987[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2010]; cf. Mount Sinai Hosp. v Auto One Ins. Co., 121 AD3d 869 [2014]).
We note that while the Civil Court dismissed the complaint as premature, the claimed services were rendered after April 1, 2013, and defendant properly denied the claims at issue on the ground that plaintiff had failed to provide the requested verification within 120 days of the initial verification request in this action (see 11 NYCRR 65-3.5 [o]; 65-3.8 [b] [3]). Therefore, defendant was entitled to dismissal of plaintiff’s complaint with prejudice, but as defendant has not cross-appealed, the order is affirmed.
PESCE, P.J., ALIOTTA and ELLIOT, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 12, 2019
Reported in New York Official Reports at GL Acupuncture, P.C. v Progressive Ins. Co. (2019 NY Slip Op 50575(U))
| GL Acupuncture, P.C. v Progressive Ins. Co. |
| 2019 NY Slip Op 50575(U) [63 Misc 3d 140(A)] |
| Decided on April 12, 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 April 12, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, DAVID ELLIOT, JJ
2017-303 K C
against
Progressive Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for appellant. McCormack & Mattei, P.C. (Jamila Shukry and Stafford Harmitt of counsel), for respondent.
Appeal, on the ground of inadequacy, from a judgment of the Civil Court of the City of New York, Kings County (Richard J. Montelione, J.), entered August 4, 2016. The judgment, after a nonjury trial, awarded plaintiff the principal sum of only $54.74.
ORDERED that the judgment is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff seeks to recover the sum of $178.58 for acupuncture services rendered by a licensed acupuncturist. At a nonjury trial, the parties stipulated that plaintiff had established its prima facie case, that defendant had timely denied the claims at issue andthat defendant’s witness was a certified coder. The Civil Court took judicial notice of the workers’ compensation chiropractic fee schedule. In her testimony, defendant’s coder explained how she had calculated the payments for the acupuncture services billed under CPT codes 97810 and 97811 based on the chiropractic fee schedule, and she testified that defendant was offering payment in the amount of $54.74 for an office visit billed under CPT code 99203. Plaintiff did not call a witness to rebut the coder’s testimony. The Civil Court, finding the testimony by defendant’s witness to be credible, determined that defendant had properly paid the claims billed under CPT codes 97810 and [*2]97811, and awarded plaintiff the principal sum of $54.74 for the office visit billed under CPT code 99203. A judgment was entered on August 4, 2016 pursuant to the decision.
Upon a review of the record, we find that the Civil Court properly determined that defendant had established that it had fully paid plaintiff for the services billed under CPT codes 97810 and 97811 in accordance with the workers’ compensation fee schedule for acupuncture services performed by chiropractors (see Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009]) and that plaintiff had failed to rebut defendant’s showing.
Accordingly, the judgment is affirmed.
PESCE, P.J., ALIOTTA and ELLIOT, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 12, 2019
Reported in New York Official Reports at Healing Art Acupuncture, P.C. v Progressive Ins. Co. (2019 NY Slip Op 50574(U))
| Healing Art Acupuncture, P.C. v Progressive Ins. Co. |
| 2019 NY Slip Op 50574(U) [63 Misc 3d 140(A)] |
| Decided on April 12, 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 April 12, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, DAVID ELLIOT, JJ
2017-116 K C
against
Progressive Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for appellant. McCormack & Mattei, P.C. (Jamila Shukry and Erin O’Neill of counsel), for respondent.
Appeal from a judgment of the Civil Court of the City of New York, Kings County (Richard J. Montelione, J.), entered August 4, 2016. The judgment, after a nonjury trial, dismissed the complaint.
ORDERED that the judgment is affirmed, with $25 costs.
At the commencement of a nonjury trial in this action by a provider to recover assigned first-party no-fault benefits, the parties stipulated that plaintiff had established its prima facie case and that defendant had timely denied the claim in question. The issue for trial was whether defendant had properly paid the bill in accordance with the workers’ compensation fee schedule. The Civil Court consolidated for trial the case at bar with GL Acupuncture, P.C., as Assignee of Gibson, Darrell v Progressive Ins. Co. ( Misc 3d , 2019 NY Slip Op [appeal No. 2017-303 K C], decided herewith). At the trial, the court took judicial notice of the workers’ compensation chiropractic fee schedule and the parties stipulated that defendant’s witness was a certified medical coder. The witness testified that she had applied the workers’ compensation chiropractic fee schedule to determine payment for the services, which had been provided by a licensed acupuncturist. In the GL Acupuncture trial, the court, finding that the testimony of defendant’s witness was credible and, noting that plaintiff had failed to rebut the testimony, [*2]determined, insofar as is relevant, that defendant had properly paid the claims for services billed under CPT codes 97810 and 97811. In the case at bar, plaintiff’s attorney told the court that he agreed with defense counsel’s statement that defendant’s witness would similarly testify that she had applied the chiropractic rate to the services, which had been provided by a licensed acupuncturist. The court found, as it did in GL Acupuncture, that defendant had correctly applied the fee schedule codes. Consequently, a judgment was entered on August 4, 2016 dismissing the complaint.
We find that defendant established that it had fully paid plaintiff for the services billed in accordance with the workers’ compensation fee schedule for acupuncture services performed by chiropractors (see Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23, 24 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009] [“we hold, as a matter of law, that an insurer may use the workers’ compensation fee schedule for acupuncture services performed by chiropractors to determine the amount which a licensed acupuncturist is entitled to receive for such acupuncture services”]) and that plaintiff failed to rebut defendant’s showing.
Accordingly, the judgment is affirmed.
PESCE, P.J., ALIOTTA and ELLIOT, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 12, 2019
Reported in New York Official Reports at Success Rehab P.T., P.C. v NY Cent. Mut. Fire Ins. Co. (2019 NY Slip Op 50572(U))
| Success Rehab P.T., P.C. v NY Cent. Mut. Fire Ins. Co. |
| 2019 NY Slip Op 50572(U) [63 Misc 3d 140(A)] |
| Decided on April 12, 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 April 12, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., MICHELLE WESTON, DAVID ELLIOT, JJ
2016-2884 K C
against
NY Central Mutual Fire Ins. Co., Respondent.
Gary Tsirelman, P.C. (Irena Golodkeyer of counsel), for appellant. Gullo & Associates, LLP (Cristina Carollo 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 10, 2016. The order, insofar as appealed from, granted the branches of defendant’s motion seeking summary judgment dismissing so much of the complaint as sought to recover upon seven claims for services provided from March 1, 2010 through September 22, 2010.
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 moved for summary judgment dismissing the complaint. Plaintiff appeals from so much of an order of the Civil Court entered August 10, 2016 as granted the branches of defendant’s motion seeking summary judgment dismissing seven claims for services provided from March 1, 2010 through September 22, 2010, which claims had been denied on the ground of lack of medical necessity.
Contrary to plaintiff’s assertion, the proof submitted by defendant in support of its motion was sufficient to give rise to a presumption that the denial of claim forms at issue had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d [*2]1123 [2008]). In support of its motion, defendant proffered an affirmed report by the doctor who had performed an independent medical examination, which report set forth a factual basis and medical rationale for the doctor’s determination that the assignor’s injuries had resolved and that there was no medical necessity for the rendered services. Defendant’s prima facie showing was not rebutted by plaintiff. Plaintiff’s remaining arguments were improperly raised for the first time on appeal (see Joe v Upper Room Ministries, Inc., 88 AD3d 963 [2011]) and, in any event, lack merit.
Accordingly, the order, insofar as appealed from, is affirmed.
PESCE, P.J., WESTON and ELLIOT, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: April 12, 2019