Mathews v. Allstate Ins.

• Decision Date: 28 July 2016
• Docket Number: 2014–2615 W C.
• Citation: 43 N.Y.S.3d 767 (Table)
• Parties: Daniel MATHEWS, M.D., Appellant, v. ALLSTATE INSURANCE, Respondent.
• Court: New York Supreme Court — Appellate Term

43 N.Y.S.3d 767 (Table)

Daniel MATHEWS, M.D., Appellant,

v.ALLSTATE INSURANCE, Respondent.

2014–2615 W C.

Supreme Court, Appellate Term, Second Dept., 9 and 10 Judicial Dist.

July 28, 2016.

Appeal from a judgment of the City Court of Yonkers, Westchester County (Arthur J. Doran, III, J.), entered June 10, 2014. The judgment, after a nonjury trial, dismissed the action.

ORDERED that the judgment is affirmed, without costs.

Plaintiff commenced this small claims action to recover assigned first-party no-fault benefits in the sum of $953.77. At a nonjury trial, plaintiff testified that he had performed certain testing on the patient, based on a referral from an orthopedic surgeon, without having inquired as to whether the testing was medically necessary. He stated that he had submitted a claim to defendant for $1,135, but only $181.23 of that claim had been paid, leaving a balance due of $953.77. Defendant's expert witness, who was board-certified in physical medicine and rehabilitation, testified that there was a lack of medical necessity for the services at issue. Following the trial, the City Court dismissed the action in a judgment entered June 10, 2014.

In a small claims action, this court's review is limited to a determination of whether "substantial justice has ... been done between the parties according to the rules and principles of substantive law" (UCCA 1807 ; see UCCA 1804 ; Ross v. Friedman, 269 A.D.2d 584 [2000] ; Williams v. Roper, 269 A.D.2d 125 [2000] ). Furthermore, the determination of a trier of fact as to issues of credibility is given substantial deference, as a trial court's opportunity to observe and evaluate the testimony and demeanor of the witnesses affords it a better perspective from which to assess their credibility (see Vizzari v. State of New York, 184 A.D.2d 564 [1992] ; Kincade v. Kincade, 178 A.D.2d 510, 511 [1991] ). This deference applies with greater force to judgments rendered in the Small Claims Part of the court (see Williams v. Roper, 269 A.D.2d at 126 ).

The issue at trial was whether the services in question were medically necessary. Plaintiff's challenge to defendant's expert witness's qualifications to testify as to the lack of medical necessity, on the ground that the witness was not an orthopedic surgeon, goes to the weight and not to the admissibility of his testimony (see Vargas v. Sabri, 115 AD3d 505 [2014] ), and the City Court, as the trier of fact, was free to accept or reject his opinion. The City Court apparently accepted defendant's expert witness's testimony and implicitly found that defendant had satisfied its burden of demonstrating that the services were not medically necessary (see Dayan v. Allstate Ins. Co., 49 Misc.3d 151[A], 2015 N.Y. Slip Op 51751[U] [App Term, 2d Dept, 2d, 11th &...