Key Takeaway
Appellate Term reverses Civil Court ruling on IME scheduling letters, finding that 48-hour cancellation notice requirement complies with No-Fault Regulations.
Independent Medical Examinations (IMEs) are a critical component of New York’s no-fault insurance system, allowing insurance carriers to verify the medical necessity and extent of claimed injuries. However, disputes frequently arise over the technical requirements for IME scheduling letters, particularly regarding what constitutes proper notice to claimants. The formatting and language of these letters can determine whether an insurance company can successfully deny benefits for a claimant’s failure to appear.
In this case, the Civil Court initially found fault with the insurance carrier’s scheduling letters because they required claimants to call within 48 hours to cancel or reschedule appointments. This ruling reflects the ongoing tension between carriers seeking to streamline the IME process and courts ensuring claimants receive adequate notice and flexibility. The Appellate Term’s reversal demonstrates how IME no-show cases can hinge on seemingly minor procedural details.
Jason Tenenbaum’s Analysis:
AP Orthopedic & Rehabilitation, P.C. v Mercury Cas. Co., 2014 NY Slip Op 51794(U)(App. Term 2d Dept. 2014)
“The Civil Court denied defendant’s motion and plaintiff’s cross motion and held that the only remaining issue for trial was the propriety of defendant’s IME scheduling letters. Defendant argues on appeal that its motion for summary judgment dismissing the complaint should have been granted.
Contrary to the determination of the Civil Court, we find that defendant’s IME scheduling letters comply with the No-Fault Regulations (see 11 NYCRR 65-3.5 ).”
The objection to the letters in this case was that the letters advised the Claimant that they should call within 48 hours if they wished to cancel or reschedule their appointment. The Civil Court found this reasoning persuasive; the Appellate Term felt otherwise, reversed and granted Defendant summary judgment.
Key Takeaway
The Appellate Term’s decision reinforces that IME scheduling letters containing 48-hour cancellation notice requirements are legally sufficient under New York’s No-Fault Regulations. This ruling provides clarity for insurance carriers regarding acceptable scheduling language and demonstrates that courts will not invalidate IME procedures based on reasonable administrative requirements designed to facilitate proper examination scheduling.
Legal Update (February 2026): Since this 2014 post, 11 NYCRR 65-3 regulations governing IME procedures may have been amended, particularly regarding scheduling notice requirements, cancellation timeframes, and standardized letter formatting. Practitioners should verify current provisions of section 65-3.5 and related subsections, as regulatory updates could affect the enforceability of IME scheduling requirements and no-show determinations.
