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Great Health Care Chiropractic, P.C. v Hertz Co.
2014 NY Slip Op 51814(U) [46 Misc 3d 130(A)]
Decided on December 17, 2014
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This opinion is uncorrected and will not be published in the printed Official Reports.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 December 17, 2014
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-1369 K C

Great Health Care Chiropractic, P.C. as Assignee of ALEXANDRIA McFARLANE, Respondent,

against

Hertz Co., Appellant.


Appeal from an order of the Civil Court of the City of New York, Kings County (Genine D. Edwards, J.), entered January 30, 2012, deemed from a judgment of the same court entered May 2, 2012 (see CPLR 5501 [c]). The judgment, entered pursuant to the January 30, 2012 order granting plaintiff's motion for summary judgment and denying defendant's cross motion for summary judgment dismissing the complaint, awarded plaintiff the principal sum of $1,310.94.

ORDERED that the judgment is reversed, without costs, so much of the order entered January 30, 2012 as granted plaintiff's motion for summary judgment is vacated, and plaintiff's motion is denied.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court which granted plaintiff's motion for summary judgment and denied defendant's cross motion for summary judgment dismissing the complaint. A judgment was subsequently entered, from which the appeal is deemed to have been taken (see CPLR 5501 [c]).

Defendant correctly argues on appeal that plaintiff's motion should have been denied because defendant proved that it had timely mailed the denial of claim form at issue (see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]), and plaintiff failed to establish that the denial was conclusory, vague or without merit as a matter of law (see Insurance Law § 5106 [a]; Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]).

However, defendant failed to establish its entitlement to summary judgment dismissing the complaint. Defendant denied the claim at issue based upon plaintiff's assignor's failure to appear for examinations under oath (EUOs) and independent medical examinations (IMEs). Defendant failed, among other things, to establish a proper practice and procedure as to the mailing of the IME scheduling notices (see St. Vincent's Hosp. of Richmond, 50 AD3d 1123; Delta Diagnostic Radiology, P.C., 17 Misc 3d 16) and failed to submit proof by someone with personal knowledge of the nonappearance of plaintiff's assignor for the EUOs in question (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]; Bright Med. Supply Co. v IDS Prop. & Cas. Ins. Co., 40 Misc 3d 130[A], 2013 NY Slip Op 51123[U] [*2][App Term, 2d, 11th & 13th Jud Dists 2013]; Alrof, Inc. v Safeco Natl. Ins. Co., 39 Misc 3d 130[A], 2013 NY Slip Op 50458[U] [App Term, 2d, 11th & 13th Jud Dists 2013]). As defendant failed to establish either of its defenses as a matter of law, its cross motion was properly denied.

Accordingly, the judgment is reversed, so much of the order entered January 30, 2012 as granted plaintiff's motion for summary judgment is vacated, and plaintiff's motion is denied. Pesce, P.J., Aliotta and Solomon, JJ., concur.


Decision Date: December 17, 2014