Key Takeaway
All Borough Group v. Utica Mutual Insurance provides crucial precedent for New York no-fault insurance IME disputes and medical provider rights.
This article is part of our ongoing ime issues coverage, with 149 published articles analyzing ime issues issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Understanding IME Disputes in New York No-Fault Insurance Cases
Independent Medical Examinations (IMEs) represent one of the most contentious aspects of New York No-Fault Insurance Law. When insurance carriers dispute the medical necessity of treatment or seek to terminate benefits, they often schedule IMEs to obtain independent medical opinions. However, the process surrounding these examinations is fraught with procedural requirements and potential pitfalls for both insurers and medical providers.
The case of All Borough Group Medical Supply, Inc. v. Utica Mutual Insurance Company highlights critical issues that frequently arise in no-fault insurance disputes. Medical supply companies, healthcare providers, and patients often find themselves navigating complex rules about IME scheduling, notification requirements, and the consequences of examination outcomes.
These disputes typically involve questions about proper notice procedures, whether IME letters need to be sent to specific parties, and what constitutes adequate compliance with statutory requirements. The stakes are high because IME results can determine whether ongoing treatment remains covered under no-fault benefits or if coverage will be discontinued.
For medical providers and patients dealing with similar situations, understanding the legal precedents established in cases like All Borough Group can be crucial for protecting their rights and ensuring proper compliance with no-fault insurance procedures. The decision addresses fundamental questions about medical necessity determinations and the procedural safeguards that must be followed in IME processes.
Jason Tenenbaum’s Analysis:
All Borough Group Medical Supply, Inc. v. Utica Mut. Ins. Co., 2011 N.Y. Slip Op. 50949(U)(App. Term 2d Dept. 2011).
I would seriously read this decision.
Key Takeaway
This case serves as an important precedent for understanding IME-related disputes in New York’s no-fault insurance system. Medical providers and patients should carefully examine this decision as it likely addresses critical procedural requirements or substantive issues that could impact future cases. Whether the dispute involves IME no-show situations, substantiated absences, or other IME-related complications, the principles established in All Borough Group may provide valuable guidance for similar disputes involving insurance carriers’ examination requirements and coverage determinations.
Legal Update (February 2026): Since this 2011 post was published, New York’s no-fault insurance regulations have undergone several revisions, particularly regarding IME notification procedures, scheduling requirements, and timeframes for examination requests. The regulatory framework governing independent medical examinations may have been modified through amendments to 11 NYCRR Part 65, and practitioners should verify current provisions regarding notice requirements and procedural compliance standards.
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Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
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Frequently Asked Questions
What is an Independent Medical Examination (IME)?
An IME is a medical examination conducted by a doctor chosen by the insurance company to evaluate the claimant's injuries and treatment. In no-fault cases, insurers use IMEs to determine whether ongoing treatment is medically necessary, whether the injuries are causally related to the accident, and whether the claimant has reached maximum medical improvement. The results of an IME can form the basis for a claim denial or cut-off of benefits.
Can I refuse to attend an IME?
No. Under New York's no-fault regulations, attending an IME when properly scheduled is a condition precedent to receiving benefits. However, the insurer must follow specific scheduling procedures — including providing reasonable notice and accommodating certain scheduling conflicts. If the insurer fails to properly schedule the IME or you have a legitimate reason for missing it, the resulting denial may be challenged.
How should I prepare for an Independent Medical Examination?
Be honest and thorough when describing your symptoms, limitations, and treatment history. Arrive on time with photo ID and be prepared for a physical examination that may test your range of motion and functional abilities. The IME doctor works for the insurance company and may spend limited time with you, so clearly communicate your ongoing symptoms. Your attorney can advise you on what to expect and review the IME report for accuracy afterward.
What is maximum medical improvement (MMI) in no-fault cases?
Maximum medical improvement (MMI) means the point at which your condition has stabilized and further treatment is unlikely to produce significant improvement. When an IME doctor determines you have reached MMI, the insurer may cut off further no-fault benefits. However, reaching MMI does not necessarily mean you have fully recovered — you may still have permanent limitations. Your treating physician can dispute the MMI finding through a detailed rebuttal affirmation.
Can I challenge an IME doctor's findings in my no-fault case?
Yes. If an IME results in a denial or cut-off of benefits, your treating physician can submit a sworn affirmation rebutting the IME findings point by point. The rebuttal should reference specific clinical findings, objective test results, and range-of-motion measurements that contradict the IME conclusions. At arbitration or trial, the fact-finder weighs both the IME report and the treating physician's opinion. An experienced no-fault attorney can identify weaknesses in the IME report.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
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