Key Takeaway
Appellate Term reverses trial court ruling that prevented insurance company from defending IME no-show case, clarifying that denied summary judgment motions don't preclude trial defenses.
Understanding IME No-Show Defenses in No-Fault Insurance Cases
Independent Medical Examinations (IMEs) serve as a crucial tool for insurance companies to verify claims under New York No-Fault Insurance Law. When patients fail to appear for scheduled IMEs, insurers often assert this as a defense to deny coverage, arguing the claimant failed to comply with policy conditions. However, procedural complications can arise when courts make premature determinations about the viability of such defenses.
The Progressive Orthopedics case demonstrates an important principle: a trial court’s denial of summary judgment doesn’t automatically eliminate an insurer’s ability to present that same defense at trial. This distinction becomes particularly significant in IME no-show cases, where the evidence supporting the defense may require thorough examination beyond what’s possible in summary judgment proceedings.
Jason Tenenbaum’s Analysis:
Progressive Orthopedics, PLLC v Hertz Corp., 2017 NY Slip Op 27193 (App. Term 2d Dept. 2017)
(1) “The Civil Court did not allow defendant to present any evidence in support of its defense that plaintiff’s assignor had failed to appear for duly scheduled IMEs, which would constitute a failure to comply with a condition precedent to coverage (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 ), because the court held that a prior order of the same court (Wavny Toussaint, J.), which had denied defendant’s summary judgment motion based on that failure to appear, had already determined that defendant could not establish that defense.”
(2) As per Vitality Chiropractic, P.C., the denial of a motion for summary judgment in and of itself establishes nothing
(3) Decision reversed
Key Takeaway
Trial courts cannot prevent insurance companies from presenting IME no-show defenses at trial simply because a previous summary judgment motion on the same issue was denied. The Appellate Term’s reversal reinforces that denied summary judgment motions don’t establish the merits of underlying defenses, ensuring parties retain their right to present evidence at trial.
