Key Takeaway
Court dismissed no-fault claim when patient failed to appear for IME after insurer proved proper notice was mailed and plaintiff couldn't contest nonappearance.
Understanding IME No-Show Cases in New York No-Fault Insurance
Independent Medical Examinations (IMEs) play a crucial role in New York No-Fault Insurance Law. When an insurance company requests an IME, the insured person must attend, or risk having their claim denied or dismissed entirely. This requirement creates a strategic burden-shifting framework in litigation.
To successfully defend against a no-fault claim based on an IME no-show, an insurance company must establish two key elements: first, that they properly mailed the IME notice according to legal requirements, and second, that the patient actually failed to appear for the examination. Once the insurer makes this prima facie showing, the burden shifts to the plaintiff to raise a triable issue regarding either the notice or the nonappearance.
The Coast Med. Diagnostic case demonstrates what happens when a plaintiff cannot effectively challenge either element. Unlike cases where IME notices weren’t properly mailed, this situation involved clear proof of proper notice and an undisputed failure to appear.
Jason Tenenbaum’s Analysis:
Coast Med. Diagnostic, PC v Praetorian Ins. Co., 2013 NY Slip Op 50381(U)(App. Term 2d Dept. 2013)
“The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the action for first-party no-fault benefits by establishing that it timely and properly mailed the notices for independent medical examinations (IMEs) to plaintiff’s assignor, and that the assignor failed to appear”…”In opposition, plaintiff did not deny the assignor’s nonappearance or otherwise raise a triable issue with respect thereto, or as to the mailing or reasonableness of the underlying notices”
Key Takeaway
When facing an IME no-show defense, plaintiffs must challenge either the adequacy of the notice or dispute the actual nonappearance. Simply remaining silent on both issues will result in summary judgment for the insurance company. This case reinforces that proper IME procedures are essential for maintaining viable no-fault claims.
Legal Update (February 2026): Since this 2013 post, New York’s IME requirements and notice procedures may have been modified through regulatory amendments or court decisions affecting burden-shifting standards in no-fault litigation. Practitioners should verify current IME notice requirements, timing provisions, and procedural standards under the most recent No-Fault regulations and case law developments.
