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Understanding IME No-Show Defense Requirements in New York No-Fault Cases
In New York’s no-fault insurance system, Independent Medical Examinations (IMEs) serve as a crucial tool for insurers to verify the medical necessity and appropriateness of claimed treatments. When a patient fails to appear for a scheduled IME, insurers can use this “no-show” as a defense to deny coverage. However, questions often arise about what level of proof is required to establish that a claimant actually failed to attend the examination.
The burden of proof for IME no-show defenses has been a source of ongoing litigation in New York courts. Insurance companies must demonstrate that they properly scheduled the examination and that the claimant failed to appear, but the specific evidentiary requirements have varied across different cases. This uncertainty has led to disputes over whether additional documentation beyond physician statements is necessary to substantiate a no-show claim.
Understanding the standards for proving IME non-attendance is essential for both healthcare providers pursuing New York no-fault insurance claims and insurers defending against such claims. The Right Aid Diagnostic Medicine case provides important clarification on this procedural issue.
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Right Aid Diagnostic Medicine, P.C. v Travelers Ins. Co., 2013 NY Slip Op 51033(U)(App. Term 2d Dept. 2013)
One of the most contentious areas involving the IME no-show defense involves the proof necessary to show that Claimant failed to attend the examination.
“Defendant also submitted an affirmation by its examining physician and affidavits by its examining chiropractor, psychologist and acupuncturist, respectively, each of which stated that plaintiff’s assignor had failed to appear for the scheduled IMEs.”
I think this is all that is necessary on motion. Examining doctor says Claimant did not show. That is it.
Key Takeaway
The Right Aid Diagnostic Medicine decision establishes a straightforward standard for proving IME no-shows: a simple statement from the examining physician that the claimant failed to appear is sufficient evidence. This ruling reduces the evidentiary burden on insurers and provides clarity for practitioners handling IME-related disputes in New York no-fault cases. The decision emphasizes practical efficiency over complex procedural requirements when establishing non-attendance at scheduled medical examinations.
Legal Update (February 2026): Since this 2013 post, New York’s no-fault insurance regulations and IME procedures may have been subject to amendments, including potential changes to evidentiary standards for establishing IME no-shows and updated procedural requirements under 11 NYCRR 65. Practitioners should verify current regulatory provisions and recent case law interpretations regarding quantum of proof requirements for IME non-attendance defenses.
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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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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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