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DELTA DIAGNOSTIC RADIOLOGY, P.C. a/a/o Vladimir Anichkin, Appellant, v. AMERICAN TRANSIT INSURANCE CO., Respondent.
Appeal from an order of the Civil Court, Queens County (Bernice Daun Siegal, J.), entered September 15, 2005. The order denied plaintiff's motion for summary judgment.
Order affirmed without costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment, inter alia, on the ground that defendant's NF-10 denial of claim form, which alleged the lack of medical necessity, failed to assert sufficient facts and a medical rationale based thereon to set forth, with the requisite specificity, a proper ground for the denial. The court denied the motion, finding the denial form's reference to a negative peer review report sufficient to apprise plaintiff of the basis of its determination that the medical services provided were medically unnecessary. Plaintiff appeals, and we affirm (A.B. Med. Servs., PLLC v. Liberty Mut. Ins. Co., 39 A.D.3d 779, 835 N.Y.S.2d 614 [2d Dept.2007] ). To the extent that A.B. Med. Servs. PLLC v. GEICO Cas. Ins. Co., 12 Misc.3d 30, 816 N.Y.S.2d 821 [App.Term, 2d & 11th Jud.Dists. 2006] and related cases are to the contrary, they should no longer be followed (see 11 NYCRR 65-3.8[b][4] ).
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Decided: June 04, 2007
Court: Supreme Court, Appellate Term, New York.
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Get help with your legal needs
FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.
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