| Karina K. Acupuncture P.C. v MVAIC |
| 2013 NY Slip Op 52127(U) [42 Misc 3d 126(A)] |
| Decided on December 13, 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
Defendant, as limited by its briefs, appeals from so much an order of the Civil Court
of the City of New York, Bronx County (Fernando Tapia, J.), entered September 25,
2012, as denied its motion for summary judgment dismissing the complaint.
Per Curiam.
Order (Fernando Tapia, J.), entered September 25, 2012, insofar as appealed from, reversed, with $10 costs, and defendant's motion for summary judgment dismissing the complaint is granted. The Clerk is directed to enter judgment accordingly.
The affidavits submitted by defendant MVAIC in support of its motion for summary
judgment established that defendant timely denied (St. Vincent's Hosp. of Richmond
v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) plaintiff's
claim for assigned first-party no-fault benefits on the ground that the fees plaintiff
charged for the acupuncture services it rendered to the assignor exceeded the amount
permitted by the applicable worker's compensation fee schedule. In opposition, plaintiff
failed to raise a triable issue as to the efficacy of defendant's mailing of the denial or the
calculation of the fee.
Nor was any triable issue raised as to whether the 30-day period to pay or deny the
claim was tolled by a proper verification request. Contrary to plaintiff's claim, defendant
may properly request verification in order to determine whether plaintiff's assignor was a
covered person entitled to receive no-fault benefits from MVAIC (see New York
Hosp. Med. Ctr. of Queens v MVAIC, 12 AD3d 429 [2004], lv denied 4
NY3d 705 [2005])
. Plaintiff's remaining challenges to the verification requests are
unpreserved.
Accordingly, defendant's motion for summary judgment dismissing the claim - which
sought the difference between the amount charged for the services and payments made to
plaintiff pursuant to the fee schedule - should have been granted.
[*3]THIS CONSTITUTES THE DECISION AND
ORDER OF THE COURT.
I concur
Decision Date: December 13, 2013