July 2, 2013

Synergy Med. v Praetorian Ins. Co. (2013 NY Slip Op 51047(U))

Headnote

The main issues in this case were whether the medical services provided by the plaintiff were medically necessary and whether the defendant-insurer was entitled to summary judgment. The court considered the chiropractor's sworn peer review report, which concluded that the services were not medically necessary according to the standards of protocol followed by the National Academy of MUA physicians. The court also considered the unsworn operative reports of the plaintiff's principal, which were found to be without probative value. The court ultimately held that the defendant-insurer made a prima facie showing of entitlement to judgment as a matter of law, and therefore granted the motion for summary judgment and dismissed the complaint.

Reported in New York Official Reports at Synergy Med. v Praetorian Ins. Co. (2013 NY Slip Op 51047(U))

Synergy Med. v Praetorian Ins. Co. (2013 NY Slip Op 51047(U)) [*1]

Synergy Med. v Praetorian Ins. Co.

2013 NY Slip Op 51047(U) [40 Misc 3d 127(A)]

Decided on July 2, 2013

Appellate Term, First 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This opinion is uncorrected and will not be published in the printed Official Reports.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 July 2, 2013

SUPREME COURT, APPELLATE TERM, FIRST DEPARTMENT

PRESENT: Hunter, Jr., J.P., Torres, Shulman, JJ
570270/13.

Synergy Medical a/a/o Marian Selby, Plaintiff-Respondent, – –
against
Praetorian Insurance Company, Defendant-Appellant.

Defendant appeals from an order of the Civil Court of the City of New York, Bronx County (Raul Cruz, J.), entered January 10, 2011, which denied its motion for summary judgment dismissing the complaint.

Per Curiam.

Order (Raul Cruz, J.), entered January 10, 2011, reversed, with $10 costs, motion granted and complaint dismissed. The Clerk is directed to enter judgment accordingly.

The defendant-insurer made a prima facie showing of entitlement to judgment as a matter of law by submitting, inter alia, a chiropractor’s sworn peer review report which set forth a factual basis and medical rationale for his stated conclusion that the medical services giving rise to plaintiff’s claim for first-party no-fault benefits were not medically necessary. Notably, defendant’s peer reviewer explained in some detail that the manipulation under anesthesia (“MUA”) procedures performed at plaintiff’s facility were not medically necessary according to the standards of protocol followed by the National Academy of MUA physicians. In opposition, plaintiff failed to raise a triable issue. The unsworn operative reports of plaintiff’s principal submitted with plaintiff’s attorney’s affirmation were without probative value (see Grasso v Angerami, 79 NY2d 813 [1991]). In any event, even if considered, the conclusory, fill-in-the-blanks findings set forth therein were insufficient to withstand summary judgment (see CPT Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co., 18 Misc 3d 87 [2007]).
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concur I concurI concur.
Decision Date: July 02, 2013