March 11, 2016

Acupuncture Healthcare Plaza I, P.C. v Truck Ins. Exch. (2016 NY Slip Op 50309(U))

Headnote

The relevant facts the court considered in the case of Acupuncture Healthcare Plaza I, P.C. v Truck Ins. Exch. involved a dispute over first-party no-fault benefits for acupuncture services rendered by the plaintiff. The defendant argued that they had properly used the workers' compensation fee schedule applicable to chiropractors who provide similar services to reimburse the plaintiff for the acupuncture services. The main issue decided by the court was whether the defendant had properly reimbursed the plaintiff for the services rendered. The holding of the case was that the defendant had established that the denial of the claim form had been timely mailed and that they had fully paid the plaintiff in accordance with the workers' compensation fee schedule for acupuncture services provided by chiropractors. Therefore, the court affirmed the order granting the defendant's motion for summary judgment dismissing the complaint.

Reported in New York Official Reports at Acupuncture Healthcare Plaza I, P.C. v Truck Ins. Exch. (2016 NY Slip Op 50309(U))

Acupuncture Healthcare Plaza I, P.C. v Truck Ins. Exch. (2016 NY Slip Op 50309(U)) [*1]

Acupuncture Healthcare Plaza I, P.C. v Truck Ins. Exch.

2016 NY Slip Op 50309(U) [50 Misc 3d 146(A)]

Decided on March 11, 2016

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This opinion is uncorrected and will not be published in the printed Official Reports.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 March 11, 2016

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

PRESENT: : PESCE, P.J., ALIOTTA and ELLIOT, JJ.
2013-1418 K C

Acupuncture Healthcare Plaza I, P.C. as Assignee of Bernard Absolv, Appellant,
against
Truck Insurance Exchange, Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Reginald A. Boddie, J.), entered May 1, 2013. 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, defendant moved for summary judgment dismissing the complaint, arguing that it had properly used the workers’ compensation fee schedule applicable to chiropractors who render the same services as acupuncturists to reimburse plaintiff for the acupuncture services plaintiff had rendered. The Civil Court granted defendant’s motion.

Contrary to plaintiff’s contention, raised in the Civil Court and on appeal, defendant established that the denial of claim form at issue had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]). Defendant further demonstrated that it had fully paid plaintiff for the services at issue 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]). Consequently, defendant established its entitlement to judgment as a matter of law.

Accordingly, the order is affirmed.

Pesce, P.J., Aliotta and Elliot, JJ., concur.

Decision Date: March 11, 2016