April 30, 2014

High Quality Med. Supplies, Inc. v Praetorian Ins. Co. (2014 NY Slip Op 50775(U))

Headnote

The relevant facts considered in this case were that the plaintiff, High Quality Medical Supplies, Inc., was seeking to recover first-party no-fault benefits from the defendant, Praetorian Ins. Co. The plaintiff moved for summary judgment, while the defendant cross-moved for summary judgment on the grounds that it had properly denied the claims based on lack of medical necessity. The Civil Court denied the plaintiff's motion and made findings in the plaintiff's favor, as well as denying the defendant's cross motion. On appeal, the defendant failed to provide a sufficient basis to strike the Civil Court's findings in the plaintiff's favor and there was a triable issue of fact regarding the medical necessity of the supplies at issue. As a result, the defendant was not entitled to summary judgment dismissing the complaint. Therefore, the Appellate Term affirmed the order in favor of the plaintiff.

Reported in New York Official Reports at High Quality Med. Supplies, Inc. v Praetorian Ins. Co. (2014 NY Slip Op 50775(U))

High Quality Med. Supplies, Inc. v Praetorian Ins. Co. (2014 NY Slip Op 50775(U))
High Quality Med. Supplies, Inc. v Praetorian Ins. Co.
2014 NY Slip Op 50775(U) [43 Misc 3d 138(A)]
Decided on April 30, 2014
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This opinion is uncorrected and will not be published in the printed Official Reports.

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


PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-492 K C
High Quality Medical Supplies, Inc. as Assignee of ALISIA TUDOR, Respondent,

against

Praetorian Ins. Co., Appellant.

[*1]

Appeal from an order of the Civil Court of the City of New York, Kings County (Reginald A. Boddie, J.), entered October 20, 2011. The order, insofar as appealed from, upon denying plaintiff’s motion for summary judgment, made CPLR 3212 (g) findings in plaintiff’s favor, and denied defendant’s cross motion for summary judgment dismissing the complaint.

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, plaintiff moved for summary judgment, and defendant cross-moved for summary judgment dismissing the complaint on the ground that it had timely and properly denied the claims at issue based on a lack of medical necessity. Insofar as is relevant to this appeal, the Civil Court, upon denying plaintiff’s motion, made CPLR 3212 (g) findings in plaintiff’s favor, and denied defendant’s cross motion.

On appeal, defendant fails to articulate a sufficient basis to strike the Civil Court’s CPLR 3212 (g) findings in plaintiff’s favor (see EMC Health Prods. as Assignee of Brian Byers v Geico Ins. Co., ___ Misc 3d ___, 2014 NY Slip Op _____ [Appeal No. 2012-1208 K C], decided herewith). Moreover, upon a review of the record, we find that there is a triable issue of fact regarding the medical necessity of the supplies at issue. As a result, defendant is not entitled to summary judgment dismissing the complaint.

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

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


Decision Date: April 30, 2014