X

Thank you for sharing!

Your article was successfully shared with the contacts you provided.

16-109. FIVE BORO MEDICAL EQUIPMENT, INC. A/A/O VERONICA HALL, plf-app, v. A. CENTRAL INS. CO., def-res — Order (Nancy M. Bannon, J.) entered August 22, 2013, reversed, with $10 costs, defendant’s motion denied, and the complaint reinstated.

The defendant-insurer’s motion for summary judgment dismissing this first-party no-fault action should have been denied. Initially, we note that Civil Court correctly determined that defendant’s documentary submissions were sufficient to establish, prima facie, that its denial of claim forms were timely and properly mailed (see Preferred Mut. Ins. Co. v. Donnelly, 22 NY3d 1169 [2014]; AutoOne Ins./General Assurance v. Eastern Island Med. Care, P.C., ___AD3d__, 2016 NY Slip Op 00916 [2016]), and that the peer review reports of defendant’s chiropractor were in admissible form (see Furtow v. Jenstro Enters., Inc., 75 AD3d 494, 495 [2010]; Collins v. AA Trucking Renting Corp., 209 AD2d 363 [1994]). However, the copy of the November 4, 2011 peer review report, ostensibly submitted by defendant to establish the lack of medical necessity for the medical supplies underlying plaintiff’s claims in the amounts of $481.55 and $540.94, was incomplete, since certain pages of the report were missing, and was thus insufficient to establish the defense of lack of medical necessity.

 
Reprints & Licensing
Mentioned in a Law.com story?

License our industry-leading legal content to extend your thought leadership and build your brand.

More From ALM

With this subscription you will receive unlimited access to high quality, online, on-demand premium content from well-respected faculty in the legal industry. This is perfect for attorneys licensed in multiple jurisdictions or for attorneys that have fulfilled their CLE requirement but need to access resourceful information for their practice areas.
View Now
Our Team Account subscription service is for legal teams of four or more attorneys. Each attorney is granted unlimited access to high quality, on-demand premium content from well-respected faculty in the legal industry along with administrative access to easily manage CLE for the entire team.
View Now
Gain access to some of the most knowledgeable and experienced attorneys with our 2 bundle options! Our Compliance bundles are curated by CLE Counselors and include current legal topics and challenges within the industry. Our second option allows you to build your bundle and strategically select the content that pertains to your needs. Both options are priced the same.
View Now
September 04, 2025
New York, NY

The New York Law Journal honors attorneys and judges who have made a remarkable difference in the legal profession in New York.


Learn More
February 24, 2025 - February 26, 2025
Las Vegas, NV

This conference aims to help insurers and litigators better manage complex claims and litigation.


Learn More
March 24, 2025
New York, NY

Recognizing innovation in the legal technology sector for working on precedent-setting, game-changing projects and initiatives.


Learn More

Our client, a thriving personal injury firm known for its commitment to compassionate client care is seeking an attorney with 5+ years of ex...


Apply Now ›

McCarter and English s Chambers-ranked Government Contracts group is seeking an experienced, diligent, and proactive government contracts as...


Apply Now ›

The Court of Appeal, First Appellate District in San Francisco is accepting applications for a central staff attorney vacancy. A regular ful...


Apply Now ›