Key Takeaway
Court applies Alrof v. Safeco ruling requiring personal knowledge for IME no-show claims, potentially limiting insurers' defense options in no-fault cases.
In New York’s no-fault insurance system, one of the most contentious issues involves Independent Medical Examinations (IMEs) and what happens when patients fail to appear. Insurance companies routinely schedule these examinations to evaluate the medical necessity of ongoing treatment, but when patients don’t show up, insurers often use this as grounds to deny claims or seek summary judgment.
The evidentiary requirements for proving an IME no-show have evolved significantly through case law. A critical development came with the Alrof v. Safeco decision, which established that insurance companies must present evidence from someone with personal knowledge of the non-appearance - not just form letters or generic affidavits. This requirement has created new challenges for insurers seeking to defend against New York No-Fault Insurance Law claims.
The personal knowledge standard means that insurers can’t simply rely on clerical workers who process paperwork but weren’t present at the scheduled examination. Instead, they need testimony from someone who was actually there and witnessed the no-show, such as the examining physician or office staff who were present during the scheduled appointment time.
Jason Tenenbaum’s Analysis:
Optimal Well-Being Chiropractic, P.C. v Hertz Co., 2013 NY Slip Op 50902(U)(App. Term 2d Dept. 2013)
“Since defendant did not submit evidence from anyone with personal knowledge of plaintiff’s assignor’s nonappearances, defendant’s cross motion for summary judgment dismissing the complaint was properly denied (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 ).”
Was this result ordained by Alfrof v. Safeco? If it is, then the future of “personal knowledge” is just not looking too promising.
Key Takeaway
This decision demonstrates how the Alrof v. Safeco personal knowledge requirement is being applied consistently across New York courts. Insurance companies can no longer rely on generic documentation to prove IME no-shows - they must present testimony from individuals who actually witnessed the non-appearance. This trend suggests that proving IME non-compliance will become increasingly challenging for insurers, potentially shifting the balance in no-fault litigation toward healthcare providers.
Legal Update (February 2026): The evidentiary standards and procedural requirements for establishing IME non-appearance have continued to evolve since this 2013 analysis, particularly regarding what constitutes sufficient “personal knowledge” and acceptable forms of documentation. Practitioners should verify current Appellate Division interpretations and any updates to Insurance Department regulations governing IME procedures and proof requirements.
