September 8, 2017

Renelique v Allstate Ins. Co. (2017 NY Slip Op 51141(U))

Headnote

The relevant facts of the case were that the plaintiff, Pierre Jean Jacques Renelique, was seeking to recover assigned first-party no-fault benefits from Allstate Insurance Company. Plaintiff had moved for summary judgment, and defendant cross-moved for summary judgment dismissing the complaint on the grounds that they had already paid the provider for the services at issue in accordance with the workers' compensation fee schedule. The main issue decided by the court was whether the defendant had properly applied the workers' compensation fee schedule to calculate the amount due for services billed, and whether the plaintiff's argument with respect to a specific CPT code was properly raised. The holding of the case was that the defendant had demonstrated that they had properly applied the workers' compensation fee schedule and the plaintiff had failed to rebut this showing. As a result, the court affirmed the order granting the defendant's motion for summary judgment dismissing the complaint.

Reported in New York Official Reports at Renelique v Allstate Ins. Co. (2017 NY Slip Op 51141(U))

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

Pierre Jean Jacques Renelique, as Assignee of Leandra, Stewart, Appellant,
against
Allstate Insurance Company, Respondent.

The Rybak Firm, PLLC (Damin J. Toell, Esq.), for appellant. Peter C. Merani, P.C. (Eric M. Wahrburg, Esq.), for respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (William A. Viscovich, J.), entered April 7, 2014. The order, insofar as appealed from as limited by the brief, upon granting defendant’s motion for leave to reargue its prior cross motion for summary judgment dismissing the complaint, which had been denied in an order of the same court (Barry A. Schwartz, J.) dated October 23, 2013, granted defendant’s prior cross motion.

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 defendant had paid plaintiff for the services at issue in accordance with the workers’ compensation fee schedule. By order dated October 23, 2013, the Civil Court (Barry A. Schwartz, J.) denied the motion and cross motion. Defendant subsequently moved for leave to reargue its cross motion and, upon reargument, for summary judgment dismissing the complaint. Insofar as is relevant to this appeal, by order entered April 7, 2014, upon granting leave to reargue, the Civil Court (William A. Viscovich, J.) granted defendant’s prior cross motion for summary judgment dismissing the complaint.

Contrary to plaintiff’s argument, defendant demonstrated that it had properly applied the workers’ compensation fee schedule to calculate the amount due for services billed under CPT code 20553, and plaintiff failed to rebut defendant’s showing (cf. Alleviation Med. Servs., P.C. v State Farm Mut. Auto. Ins. Co., 47 Misc 3d 149[A], 2015 NY Slip Op 50778[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]). Plaintiff’s argument with respect to CPT code 99203 is improperly raised for the first time on appeal.

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

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

Paul Kenny
Chief Clerk
Decision Date: September 08, 2017