Viviane Etienne Medical Care PC v. GEICO Gen'l Ins.

APPELLATE TERM
SECOND DEPARTMENT
Insurance Law

New York Law Journal

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Per Curiam

Medical provider Viviane Etienne Medical Care (VEMC) appealed from a Kings County Civil Court order granting insurer GEICO's motion for summary judgment dismissing the complaint. VEMC sought to recover assigned first-party no-fault benefits, and now appealed. GEICO, in support of its cross-motion, submitted affirmed independent medical examination reports setting forth a factual basis and medical rationale for the conclusion there was a lack of medical necessity for certain services on various dates. The panel found GEICO established its prima facie entitlement to summary judgment on those claims, noting as VEMC failed to rebut such showing, GEICO's cross-motion for summary judgment dismissal on certain claims was properly granted. Yet, the panel further found that GEICO's cross-motion for summary judgment dismissal regarding claims for service on April 13, 2005 and May 17, 2005 should have been denied ruling GEICO failed to proffer sufficient evidence to establish these claims were improperly billed or were in excess of the amount permitted by the fee schedule. As such, the panel reversed the judgment regarding such claims.

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