New York Diagnostic Med. Care, P.C. v Geico Gen. Ins. Co., 2013 NY Slip Op 23360 (App. Term 2d Dept. 2013)
The Court opened up the door today to allow appeals of orders denying partial summary judgment as to the issue of “prima facie” and “timely denials”. The lead case on this issue seemed to suggest otherwise B.Y., M.D., P.C. v Government Empl. Ins. Co., 26 Misc.3d 95 (App. Term 2d Dept. 2010). But in B.Y., Plaintiff specifically moved for “partial summary judgment” seeking judicial findings that the bills were submitted, overdue and constituted business records.
Here, “plaintiff moved for summary judgment or, in the alternative, for a finding, pursuant to CPLR 3212 (g), that plaintiff had established, for all purposes in the action, the submission to defendant of the claim forms and the fact and the amount of the loss sustained”
“plaintiff moved for summary judgment or, in the alternative, for a finding, pursuant to CPLR 3212 (g), that plaintiff had established, for all purposes in the action, the submission to defendant of the claim forms and the fact and the amount of the loss sustained. Thus, in the particular circumstances of this case, including the fact that the Civil Court did make a CPLR 3212 (g) finding as to the timely mailing of the denials and did limit the issues for trial, we find that it is appropriate to make a finding, pursuant to CPLR 3212 (g), that plaintiff established, for all purposes in the action, the submission to defendant of the claim forms and the fact and the amount of the loss sustained, and to therefore further limit the trial to the issue of medical necessity only.”
The court therefore concluded that the sole issue for trial is whether the services lack medical necessity
