Key Takeaway
Court ruling clarifies that insurance companies can use apartment numbers in IME scheduling letters even if not on original claim forms, with proper affidavit evidence.
IME Scheduling Letters: Inclusion of Apartment Numbers
Independent Medical Examinations (IMEs) are a crucial component of New York no-fault insurance law, allowing insurance companies to verify the medical necessity and extent of claimed injuries. One procedural issue that occasionally arises is the proper addressing of IME scheduling letters to claimants. A recent court decision provides important guidance on whether insurance companies can include apartment numbers in scheduling letters when those apartment numbers don’t appear on the original claim forms.
This ruling has significant implications for both insurance companies and healthcare providers who regularly deal with IME scheduling requirements and the potential complications that can arise when IME scheduling letters aren’t properly delivered.
Jason Tenenbaum’s Analysis:
Prime Diagnostic Med., P.C. v New York Cent. Mut. Fire Ins. Co., 2016 NY Slip Op 51523(U)(App. Term 2d Dept. 2016)
“Plaintiff’s argument, that the address used on the IME scheduling letters improperly included an apartment number that does not appear on plaintiff’s claim forms, will not be considered, as it is being raised for the first time on appeal (see Joe v Upper Room Ministries, Inc., 88 AD3d 963 ; Gulf Ins. Co. v Kanen, 13 AD3d 579 ; Mind & Body Acupuncture, P.C. v Elrac, Inc., 48 Misc 3d 139, 2015 NY Slip Op 51219 ). In any event, the affidavit of defendant’s litigation examiner stated that defendant used the address set forth on the assignor’s application for no-fault benefits.”
This case seems to suggest that an affidavit attesting to what is on an NF-2 is sufficient evidence to prove the basis of the address on an IME scheduling letter.
Key Takeaway
Insurance companies can include apartment numbers in IME scheduling letters even when those numbers don’t appear on original claim forms, provided they have proper documentation such as an affidavit showing the address came from the applicant’s no-fault benefits application. However, this argument must be raised at the trial level, not for the first time on appeal.
