Alleviation Med. Servs., P.C. v. Truck Ins. Exch.

• Court: Appellate Terms of the Supreme Court of New York
• Decided: March 17, 2016
• Docket: 2016 NYSlipOp 50382(U)
• Status: Published

Opinion

Alleviation Medical Services, P.C. as Assignee of JAMES WHITE, Appellant,

against

Truck Insurance Exchange, Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Jodi Orlow, J.), entered May 21, 2013. The order granted defendant's motion for summary judgment dismissing the complaint and denied plaintiff's cross motion for summary judgment.

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 and denied plaintiff's cross motion for summary judgment.

In support of its motion, defendant sufficiently established the timely mailing (see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) of the denial of claim form at issue, which denied the claim on the ground of lack of medical necessity. Defendant further submitted an affirmed peer review which set forth a factual basis and medical rationale for the peer reviewer's determination that there was a lack of medical necessity for the services at issue. In opposition to the motion, plaintiff submitted an affidavit from a doctor which failed to meaningfully refer to, let alone sufficiently rebut, the conclusions set forth in the peer review report (see Pan Chiropractic, P.C. v Mercury Ins. Co., 24 Misc 3d 136[A], 2009 NY Slip Op 51495[U] [App Term, 2nd Dept, 2d, 11th & 13th Jud Dists 2009]). Consequently, defendant established its entitlement to summary judgment dismissing the complaint.

Accordingly, the order is affirmed.

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

Decision Date: March 17, 2016