Healthy Way Acupuncture, P.C. v. Clarendon Natl. Ins. Co.

Healthy Way Acupuncture, P.C., a/a/o Leonar Sierra, Plaintiff-Respondent, against Clarendon National Ins. Co., Defendant-Appellant. Defendant, as limited by its briefs, appeals from that portion of an order of the Civil Court of the City of New York, New York County (Debra Rose Samuels, J.), entered February 27, 2015, which denied its motion for summary judgment. Per Curiam. Order (Debra Rose Samuels, J.), entered February 27, 2015, insofar as appealed from, affirmed, with $10 costs. This action, seeking recovery of assigned first-party no-fault benefits, is not ripe for summary disposition. The proof submitted by defendant was insufficient to establish, prima facie, that the amounts charged by plaintiff for the services rendered exceeded the rates set forth in the workers' compensation fee schedule (see Devonshire Surgical Facility, LLC v Allstate Ins. Co., 38 Misc 3d 127[A], 2012 NY Slip Op 52351[U] [App Term, 1st Dept 2012]; Doctor Richard Med., P.C. v Praetorian Ins. Co., 37 Misc 3d 128[A], 2012 NY Slip Op 51909[U] [App Term, 1st Dept 2012]; MIA Acupuncture, P.C. v Praetorian Ins. Co., 35 Misc 3d 69 [2011]). Contrary to plaintiff's contention, the proof submitted establishes that plaintiff's bill for services in the amount of $1,495 was timely denied, inasmuch as the 30-day statutory period was tolled by defendant's timely verification and follow-up requests (see 11 NYCRR 65-3.8[a][1]; Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 25 NY3d 498 [2015]). THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT. I concur I concur I concur Decision Date: March 24, 2017