East Coast Acupuncture, P.C. v Clarendon Natl. Ins. Co., 2011 NY Slip Op 51229(U)(App. Term 2d Dept. 2011)
“With respect to the unpaid portions of the remaining bills which defendant claims were timely denied based upon the fee schedules, the letters from defendant to plaintiff which were annexed to defendant’s motion papers and which advised plaintiff that the processing of its bills was being delayed pending an examination under oath were insufficient to toll the 30-day period within which defendant was required to pay or deny those bills (see Insurance Law § 5106 [a]; Insurance Department Regulations [11 NYCRR] § 65-3.5 [a]; see also Westchester Med. Ctr. v Lincoln Gen. Ins. Co., 60 AD3d 1045 [2009])”
One Response
Compare this case to Unitrin v. Bayshore. Evidenly EUOs are subject to the preclusion rule while IME’s stand on a differnt footing. This does not make sense and the Court of Appeals should clarify the issue instead of walking away as they did in Unitrin. No-fault Law is now in state of flux.