Allstate Ins. Co. v. Buffalo Neurosurgery Group
The plaintiff, Allstate Insurance Company, appealed an order from the Supreme Court, Nassau County, which denied its motion for summary judgment on a complaint seeking a de novo determination of no-fault insurance benefits and, upon searching the record, awarded summary judgment to the defendant, Buffalo Neurosurgery Group. The case originated from a motor vehicle accident where Christopher Krull underwent spinal fusion surgery. The defendant, as Krull's assignee, submitted a claim for no-fault benefits, which Allstate denied. The matter proceeded through arbitration, with the master arbitrator affirming an award to the defendant. The Appellate Division modified the Supreme Court's order. It granted Allstate's motion for summary judgment on the grounds that the amount of benefits sought by the defendant was not in accordance with the workers' compensation fee schedule, and it deleted the provision awarding summary judgment to the defendant. The court affirmed the denial of Allstate's motion concerning the medical necessity of the surgery, stating Allstate failed to meet its prima facie burden on that issue. The order was affirmed as modified, with costs payable to the plaintiff.