November 9, 2015

IMA Acupuncture, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51633(U))

Headnote

The relevant facts of the case were that plaintiff IMA Acupuncture, P.C. sought to recover first-party no-fault benefits that had been assigned to them. Defendant Praetorian Insurance Company cross-moved for summary judgment to dismiss the complaint on the grounds that they had timely and properly denied the claims due to plaintiff's assignor's failure to appear for scheduled independent medical examinations (IMEs). The main issue decided by the court was whether the plaintiff's assignor had failed to appear for the IMEs, and the court held that the only issue for trial was this matter. The court determined that defendant failed to establish its entitlement to summary judgment dismissing the complaint, as they did not provide sufficient evidence to prove the nonappearance of plaintiff's assignor for the IMEs, and therefore, the court affirmed the order denying the defendant's cross-motion for summary judgment.

Reported in New York Official Reports at IMA Acupuncture, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51633(U))

IMA Acupuncture, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51633(U)) [*1]

IMA Acupuncture, P.C. v Praetorian Ins. Co.

2015 NY Slip Op 51633(U)

Decided on November 9, 2015

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This opinion is uncorrected and will not be published in the printed Official Reports.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 November 9, 2015

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-1153 Q C

IMA Acupuncture, P.C. as Assignee of ELISKA DUPUY, Respondent,
against
Praetorian Insurance Company, Appellant.

Appeal from an order of the Civil Court of the City of New York, Queens County (Maureen A. Healy, J.), entered April 22, 2013. The order, insofar as appealed from and as limited by the brief, 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 upon plaintiff’s assignor’s failure to appear for duly scheduled independent medical examinations (IMEs). By order entered April 22, 2013, insofar as appealed from and as limited by the brief, the Civil Court denied defendant’s cross motion and held that the sole issue for trial was whether plaintiff’s assignor had failed to appear for duly scheduled IMEs (see CPLR 3212 [g]).

While defendant submitted a sworn statement by the chiropractor who had been scheduled to perform the IMEs, the chiropractor failed to demonstrate by personal knowledge (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]), or by any other appropriate means (see e.g. Quality Psychological Servs., P.C. v Interboro Mut. Indem. Ins. Co., 36 Misc 3d 146[A], 2012 NY Slip Op 51628[U] [App Term, 2d, 11th & 13th Jud Dists 2012]), the nonappearance of plaintiff’s assignor for both of the IMEs. Therefore, defendant failed to establish its entitlement as a matter of law to summary judgment dismissing the complaint (see Stephen Fogel Psychological, P.C., 35 AD3d 720; Bright Med. Supply Co. v IDS Prop. & Cas. Ins. Co., 40 Misc 3d 130[A], 2013 NY Slip Op 51123[U] [App Term, 2d, 11th & 13th Jud Dists 2013]; Quality Health Prods. v Hertz Claim Mgt. Corp., 36 Misc 3d 154[A], 2012 NY Slip Op 51722[U] [App Term, 2d, 11th & 13th Jud Dists 2012]).

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

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

Decision Date: November 09, 2015