Key Takeaway
A simple spelling error in an IME scheduling letter caused an insurance company's no-show defense to collapse, highlighting the importance of accurate patient identification.
In New York no-fault insurance law, insurance companies frequently schedule Independent Medical Examinations (IMEs) to evaluate the extent of a patient’s injuries and medical necessity of ongoing treatment. When patients fail to appear for these examinations, insurers typically use this as grounds to deny claims or seek summary judgment dismissing lawsuits.
However, as this case demonstrates, even seemingly minor administrative errors can have significant consequences for insurance companies’ IME defenses. The accuracy of patient identification in scheduling letters is crucial, as courts require proper notice to establish a valid no-show substantiated defense. This case serves as a reminder that attention to detail in IME procedures can make or break an insurer’s position.
Jason Tenenbaum’s Analysis:
Bay Ls Med. Supplies, Inc. v Chubb Indem. Ins. Co., 2015 NY Slip Op 50790(U)(App. Term 2d Dept. 2014)
This is the first time I saw a spelling error cause an IME defense to fold. But the error here is significant enough to raise an issue of fact on the issue as to proper notification and a poor case to appeal.
“As it cannot be said, as a matter of law, that the IME scheduling letters addressed to John Canela provided sufficient notice that plaintiff’s assignor, Jhonffi Canela (misspelled “Johnfi” by plaintiff in the summons and complaint), was to appear for the IMEs, the Civil Court properly denied defendant’s cross motion for summary judgment dismissing the complaint.”
Key Takeaway
While IME letters do not need to be sent to provider entities, they must accurately identify the patient scheduled for examination. Courts will not grant summary judgment on IME no-show defenses when spelling errors in patient names create questions about whether proper notice was given, even if the misspelling originated in the plaintiff’s own complaint.
