May 25, 2018

Compas Med., P.C. v 21st Century Ins. Co. (2018 NY Slip Op 50773(U))

Headnote

The court considered the fact that the defendant had fully paid the plaintiff for services rendered prior to April 1, 2013, in accordance with the workers' compensation fee schedule. The main issue decided was that the proof submitted by the defendant was sufficient to demonstrate that they had properly used the workers' compensation fee schedule to determine the amount which the plaintiff was entitled to receive for the services at issue. The holding of the court was that the order granting the defendant's motion for summary judgment dismissing the complaint was affirmed, with $25 costs.

Reported in New York Official Reports at Compas Med., P.C. v 21st Century Ins. Co. (2018 NY Slip Op 50773(U))

Compas Med., P.C. v 21st Century Ins. Co. (2018 NY Slip Op 50773(U)) [*1]

Compas Med., P.C. v 21st Century Ins. Co.

2018 NY Slip Op 50773(U) [59 Misc 3d 147(A)]

Decided on May 25, 2018

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This opinion is uncorrected and will not be published in the printed Official Reports.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 May 25, 2018

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

PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, DAVID ELLIOT, JJ
2016-146 K C

Compas Medical, P.C., as Assignee of Icart, Lisanda, Appellant,
against
21st Century Insurance Company, Respondent.

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

Appeal from an order of the Civil Court of the City of New York, Kings County (Reginald A. Boddie, J.), entered September 8, 2015. 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 it had fully paid plaintiff for the services at issue, which had been rendered prior to April 1, 2013, in accordance with the workers’ compensation fee schedule.

Contrary to plaintiff’s contention, the proof submitted by defendant in support of its motion was sufficient to give rise to a presumption that the denial of claim forms had been properly mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) and to demonstrate that defendant had properly used the workers’ compensation fee schedule to determine the amount which plaintiff was entitled to receive for the services at issue.

Accordingly, the order is affirmed.

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

ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 25, 2018