Acupuncture Healthcare Plaza I, P.C. v. Metlife Auto & Home
The case involves Acupuncture Healthcare Plaza I, P.C., as assignee of Boris Goldbaum, suing Metlife Auto & Home for first-party no-fault benefits. The defendant had paid a reduced sum, arguing the remaining amount exceeded the workers' compensation fee schedule and that one claim was subject to a policy deductible. During a nonjury trial, the parties stipulated to the plaintiff's prima facie case and timely denials. The defendant sought judicial notice of the workers' compensation fee schedule but failed to provide a witness to testify on its proper utilization or evidence for the deductible reduction. The Civil Court granted judgment to the plaintiff, which was subsequently affirmed by the Appellate Term, Second Department. The Appellate Term noted that while judicial notice of the fee schedule is permissible, the party seeking it must provide sufficient information and notice to the adverse party, and the fee schedule alone doesn't prove proper utilization of codes or reduction due to a deductible without supporting evidence.