Key Takeaway
PR Medical v Praetorian: a delay letter did not establish tolling. The provider won judgment; Jason's scheduling-letter explanation is distinguished.
This article is part of our ongoing ime issues coverage, with 149 published articles analyzing ime issues issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Last reviewed: September 2026.
Historical note: PR Medical (2016) rejected the asserted toll on its record and precluded a medical-necessity defense; it did not hold that all preclaim examinations are invalid.
A letter saying payment was delayed pending IMEs did not establish a toll in PR Medical v Praetorian. On March 21, 2016, the Appellate Term, First Department reversed the order under review, denied the insurer’s motion, reinstated the complaint and granted the provider’s cross motion on the appealed claims.
The tolling result and Jason’s inference
The appeal was available because the Civil Court had considered the merits on reargument, even though it described the request as denied. On the merits, the provider proved overdue claims and the insurer failed to raise a factual issue about a timely denial or an effective verification toll. The lack-of-medical-necessity defense was therefore precluded.
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Jason inferred that the scheduling letters had not been submitted. The published opinion does not expressly make that finding or announce an attachments-only rule. It says the delay letter was insufficient and the record did not otherwise show a toll from preclaim verification. Sound Shore (2013), which it cites, concerns the claim-form and follow-up chronology. Neither point should be rewritten as a prohibition on preclaim IMEs: Gaines (2025) separately addresses a properly proven preclaim IME coverage defense. A file review needs to keep the payment clock separate from the claimed coverage defense.
Jason’s original note
Jason’s original 2016 interpretation follows. The court did not expressly find that scheduling letters were omitted; his account of his office’s response is preserved as his own recollection.
If you are trying to decipher this one, I think I might have the answer here. In order to toll the time to pay or deny when a bill is delayed for an IME or EUO, the carrier besides putting in the bill delay must also put in the submissions the EUO or IME scheduling letters. That was not done here. For may of us, just keep an eye on this – I just instructed my office to keep an eye on this subtle issue. It has happened to all of us at some point.
Connect to the Encyclopedia
Start with the IME no-show case directory, then compare these related records:
- Mind & Body: the address objection first raised on appeal
- Valdan: different denial grounds across four claims
- Marina: mailing and nonattendance proof that supported dismissal
- T & J: sworn statements without demonstrated personal knowledge
For review of a particular claim, our no-fault defense practice can assess the notices, denials and motion papers. Contact the office to discuss the file. For broader background, see New York no-fault insurance law.
Legal Context
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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