New York Supreme and/or Appellate Courts SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
August 27, 2012
VE MEDICAL CARE, P.C. AS ASSIGNEE OF JORGE CORTE, APPELLANT,
NY CENTRAL MUTUAL FIRE INS. CO., RESPONDENT.
Appeal from an order of the Civil Court of the City of New York, Kings County (Lisa S. Ottley, J.), entered April 29, 2010.
VE Med. Care, P.C. v NY Cent. Mut. Fire Ins. Co.
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This opinion is uncorrected and will not be published in the printed Official Reports.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 August 27, 2012
PRESENT: PESCE, P.J., RIOS and ALIOTTA, JJ
The order granted defendant's motion for summary judgment dismissing the complaint.
ORDERED that the order is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court granting defendant's motion for summary judgment dismissing the complaint on the ground of lack of medical necessity.
Contrary to plaintiff's arguments on appeal, the affidavit submitted
by defendant's litigation examiner was sufficient to establish that
defendant had timely denied the claims (see St. Vincent's Hosp. of
Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ; Delta
Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App
Term, 2d & 11th Jud Dists 2007]). In addition, defendant submitted an affirmed independent medical
examination report which set forth a factual basis and a medical rationale for the doctor's determination
that there was a lack of medical necessity for the services at issue. Defendant's prima facie showing
was not rebutted by plaintiff. As plaintiff's remaining contentions lack merit, defendant was entitled to
summary judgment dismissing the complaint (see Delta Diagnostic Radiology, P.C. v Integon Natl. Ins.
Co., 24 Misc 3d 136[A], 2009 NY Slip Op 51502[U] [App Term, 2d, 11th & 13th Jud Dists 2009]).
Accordingly, the order is affirmed.
Pesce, P.J., Rios and Aliotta, JJ., concur.
Decision Date: August 27, 2012
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