Dugo v. State Farm Mutual Auto Ins.

RICHMOND COUNTY
Insurance Law

New York Law Journal

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Judge Philip S. Straniere

Separate suits brought by a provider in these two first-party, no-fault actions related to the same patient for the same services, at the same time and place for injuries received in the same motor vehicle accident concerning common issues of law and fact warranted trying the cases together. Provider rendered chiropractic services in the form of manipulation under anesthesia (MUA). Insurer denied coverage, alleging the MUA was not medically necessary. The court noted that chiropractors in New York cannot perform MUAs because they are classified as surgery and chiropractors are not permitted to perform surgery. Even though the procedures here were performed in New Jersey, where chiropractors are permitted to perform the procedure, the court stated the insured was covered by a New York policy and New York no-fault law. Thus, the court ruled the cases should be dismissed, granting judgment for defendant. However, the court also noted that, in the event the MUA was authorized by an appellate court or statute, then, based on the failures of the insurer to prove its case and establish a lack of medical necessity, plaintiffs would be entitled to collect on their causes of action.

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