Home Care Ortho. Med. Supply, Inc. v American Manufactures Mut. Ins. Co.
Annotate this CaseDecided on February 26, 2007
APPELLATE TERM OF THE SUPREME COURT, FIRST DEPARTMENT
PRESENT: McKeon, P.J., McCooe, Schoenfeld, JJ
570580/06.
Home Care Ortho. Med. Supply, Inc. a/a/o Gui Yaing Xiao, Bing Yong Gao, Jason Ng, Plaintiff-Respondent,
against
American Manufactures Mutual Insurance Co. d/b/a Kemper Insurance Co., Defendant-Appellant.
Defendant appeals from an order of the Civil Court of the City of New York, Bronx County (Raul Cruz, J.), dated January 30, 2006, which granted plaintiff's motion for a directed verdict.
PER CURIAM
Order (Raul Cruz, J.), dated January 30, 2006, reversed, without costs, motion denied, and matter remanded for trial.
In this action to recover assigned, first party no-fault benefits, plaintiff moved to preclude defendant's expert's testimony on the ground that the expert did not personally undertake the peer review underlying defendant's denial of the two claims here at issue. This was error, since the expert would be subject to full cross-examination and his testimony as to lack of medical necessity would be limited to the basis for denial set forth in the original peer review report (see generally General Acc. Ins. Group v Cirucci, 46 NY2d 862, 864 [1979]). Nor is defendant's expert precluded from testifying because his opinion is based, at least in part, on his review of the assignors' medical records. Plaintiff may not be heard to challenge the reliability of the assignors' medical records and reports, which, in response to defendant's verification requests, were affirmatively relied upon by plaintiff as proof of claim.
This constitutes the decision and order of the court.
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Decision Date: February 26, 2007
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