Key Takeaway
New York court rules on timely denial requirements for IME/EUO no-show cases, questioning continued reliance on 2009 Westchester/Lincoln precedent despite newer case law.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co., 2014 NY Slip Op 50954(U)(App. Term 2d Dept. 2014)
“A review of the record reveals that there is a question of fact as to whether defendant timely denied plaintiff’s claims after plaintiff’s assignor had failed to appear for duly scheduled independent medical examinations. Contrary to defendant’s contention, such a defense is subject to preclusion if defendant’s denial of claim forms were untimely (see Westchester Med. Ctr. v Lincoln Gen. Ins. Co., 60 AD3d 1045 , lv denied 13 NY3d 714 ; see also Eastern Star Acupuncture, P.C. v American Tr. Ins. Co., 33 Misc 3d 141, 2011 NY Slip Op 52205 ; but see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559 , lv denied 17 NY3d 705 ).”
There are two cases from 2014 from the Appellate Division that state a timely disclaimer is a part of an insurance carriers prima facie case on an EUO/IME no-show matter. Why does this Court insist on citing the 2009 Westchester/Lincoln case. Much has happened in five years. And the Court in IDS left open the timliness argument by not reaching it. Perhaps, this Court could reach it as Westchester/Lincoln has been called into question. I don’t understand this Court sometimes.
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Legal Update (February 2026): Since this 2014 post, New York courts have continued to develop the law regarding timely denials in EUO/IME non-appearance cases, potentially clarifying or modifying the precedential value of the Westchester/Lincoln decision cited. Practitioners should verify current caselaw and any regulatory changes to disclaimer timing requirements, as appellate decisions over the past decade may have further refined the standards for what constitutes a timely denial defense in no-fault insurance matters.
