October 11, 2019

Spine Care of NJ, P.C. v Global Liberty Ins. Co. of N.Y. (2019 NY Slip Op 51632(U))

Headnote

The court considered an appeal from an order of the Civil Court of the City of New York, Kings County granting the branches of plaintiff's cross motion seeking summary judgment on bills for services rendered on specific dates. The main issue decided was whether the plaintiff was entitled to summary judgment on the bills for services rendered on December 21, 2016 and December 29, 2016. The court held that the branches of plaintiff's cross motion seeking summary judgment on these bills should have been denied, as the evidence submitted failed to establish that the claims had not been timely denied or that the defendant had issued timely denial of claim forms that were conclusory, vague, or without merit as a matter of law. Therefore, the court reversed the order and denied the branches of plaintiff's cross motion seeking summary judgment on the bills for services rendered on those dates.

Reported in New York Official Reports at Spine Care of NJ, P.C. v Global Liberty Ins. Co. of N.Y. (2019 NY Slip Op 51632(U))

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

Spine Care of NJ, P.C., as Assignee of Nohelia Francechi, Respondent,
against
Global Liberty Insurance Company of New York, Appellant.

Law Office of Jason Tenenbaum, P.C. (Jason Tenenbaum 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 (Sharon Bourne-Clark, J.), entered June 14, 2018. The order, insofar as appealed from and as limited by the brief, granted the branches of plaintiff’s cross motion seeking summary judgment on so much of the complaint as sought to recover on bills for services rendered on December 21, 2016 and December 29, 2016.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and the branches of plaintiff’s cross motion seeking summary judgment on so much of the complaint as sought to recover on bills for services rendered on December 21, 2016 and December 29, 2016 are denied.

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 granted the branches of plaintiff’s cross motion seeking summary judgment on so much of the complaint as sought to recover on bills for services rendered on December 21, 2016 and December 29, 2016.

The branches of plaintiff’s cross motion seeking summary judgment on so much of the complaint as sought to recover on bills for services rendered on December 21, 2016 and December 29, 2016 should have been denied, as the proof submitted by plaintiff failed to establish that the claims had not been timely denied (see Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 25 NY3d 498 [2015]), or that defendant had issued timely denial of claim [*2]forms that were conclusory, vague or without merit as a matter of law (see Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]; Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128[A], 2011 NY Slip Op 51292[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]).

Accordingly, the order, insofar as appealed from, is reversed, and the branches of plaintiff’s cross motion seeking summary judgment on so much of the complaint as sought to recover on bills for services rendered on December 21, 2016 and December 29, 2016 are denied.

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

ENTER:
Paul Kenny
Chief Clerk
Decision Date: October 11, 2019