Ema Acupuncture, P.C. v Geico Ins. Co., 2014 NY Slip Op 50415(U)(App. Term 2d Dept. 2014)
Not sure why Kings County is the only venue where Great Wall does not apply and a substitute peer gets knocked out of the box, save 2-3 judges, despite the legion of caselaw which says otherwise. Add the briefing schedule which is the ultimate technicality and you have pure entropy. How many times has a plaintiff or a defendant been prejudiced due to a violation of the briefing schedule?
I digress for good reason. Here, the Court refused to comply with Great Wall. And once again, the Appellate Term says otherwise.
(1) “As to plaintiff’s remaining claims, defendant demonstrated that it had fully paid plaintiff for those services in accordance with the workers’ compensation fee schedule for acupuncture services performed by chiropractors (see Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23 [App Term, 2d, 11th & 13th Jud Dists 2009]). In opposition, plaintiff relied upon an affirmation from plaintiff’s counsel which failed to establish the existence of a triable issue of [*2]fact.”
(2) “Defendant did not raise any issue warranting the dismissal of plaintiff’s claim for $154.29 for the initial acupuncture visit on January 6, 2009, billed for under fee schedule treatment code 99205”
(3) “Defendant’s contention that plaintiff is barred from recovering attorney’s fees with respect thereto pursuant to Insurance Department Regulations (11 NYCRR) § 65-4.6 (i) lacks merit.”
(LMS Acupuncture, P.C. v Geico Ins. Co., 2014 NY Slip Op 50416(U)(App. Term 2d Dept. 2014))
