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14-144 KARINA K. ACUPUNCTURE P.C., A/A/O RIGAUD CARRENARD, plfapp, v. STATE-WIDE INSURANCE CO. def-res

14-144 KARINA K. ACUPUNCTURE P.C., A/A/O RIGAUD CARRENARD, plfapp, v. STATE-WIDE INSURANCE CO. def-res. — Order (James E. d'Auguste, J.), entered September 17, 2013, modified by reinstating plaintiff's claim for first-party no-fault benefits in the sum of $1,259.53; as modified, order affirmed, without costs.

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14-144 KARINA K. ACUPUNCTURE P.C., A/A/O RIGAUD CARRENARD, plfapp, v. STATE-WIDE INSURANCE CO. def-res. — Order (James E. d’Auguste, J.), entered September 17, 2013, modified by reinstating plaintiff’s claim for first-party no-fault benefits in the sum of $1,259.53; as modified, order affirmed, without costs.

The affidavits and other documentary evidence submitted by defendant established prima facie that defendant timely denied that portion of plaintiff’s first-party no-fault claim seeking payment of $1,182.53 — stemming from acupuncture services rendered by plaintiff during the period October 1, 2009 through October 21, 2009 — on the ground that the fees plaintiff charged exceeded the amount permitted by the applicable workers’ compensation fee schedule (see Akita Med. Acupuncture, P.C. v. Clarendon Ins. Co., 41 Misc 3d 134[A], 2013 NY Slip Op 51860[U][App Term, 1st Dept 2013]; Great Wall Acupuncture v. Geico Ge. Ins. Co., 16 Misc 3d 23 [2007]). In opposition, plaintiff failed to raise a triable issue as to the efficacy of defendant’s mailing of the denial form issued in connection with this claim or the calculation of the fee. Accordingly, defendant’s motion, insofar as it sought to dismiss the $1,182.53 claim — representing the difference between the amount charged for the services rendered and payment made to plaintiff pursuant to the fee schedule — was properly granted.

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