Key Takeaway
Court rules State Farm properly paid acupuncture claims using workers' compensation fee schedule for chiropractor services under New York no-fault insurance law.
Mind & Body Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co., 2022 NY Slip Op 50603(U)(App. Term 2d Dept. 2022)
“In support of its motion, defendant made a prima facie showing of its entitlement to summary judgment dismissing the complaint by demonstrating that it had fully paid plaintiff for the acupuncture services at issue in accordance with the workers’ compensation fee schedule for acupuncture services performed by chiropractors (see S.O.V. Acupuncture, P.C. v Global Liberty Ins. Co. of NY, 68 Misc 3d 132, 2020 NY Slip Op 51004 ) and that the subject claims sought the difference between the amount plaintiff charged for the services rendered and the payments made. In opposition, plaintiff failed to demonstrate the existence of a triable issue of fact (see Master Cheng Acupuncture, P.C. v Global Liberty Ins. of NY, 69 Misc 3d 143, 2020 NY Slip Op 51371 ; S.O.V. Acupuncture, P.C. v Global Liberty Ins. Co. of NY, 2020 NY Slip Op 51004; cf. Global Liberty Ins. Co. of NY v Acupuncture Now, P.C., 178 AD3d 512 ).”
Three citations to a defunct insurance carrier. Two stand for the chiropractor fee schedule proposition, one stands for “it depends”. The one where “it depends” is quickly c.f.’d…
Related Articles
Common Questions
Frequently Asked Questions
What is New York's no-fault insurance system?
New York's no-fault insurance system requires all drivers to carry Personal Injury Protection (PIP) coverage. This pays for medical expenses and lost wages regardless of who caused the accident, up to policy limits. However, you can only sue for additional damages if you meet the 'serious injury' threshold.
