IME no show disclaimer substantiated

In Longevity Medical Supply v Citiwide Auto Leasing, the IME notices preceded the claim. After the claim arrived, Citiwide timely sought written verification and then timely denied it when that verification came in. That sequence supported dismissal. The court did not hold that a verification request pauses every statutory or regulatory deadline.

Historical note — Last reviewed: September 2026. The 2017 ruling accepted a particular IME and written-verification sequence; Burke Physical Therapy (2024) distinguishes the payment/denial toll from the deadline to request new verification, and the IME directory supplies later no-show comparisons.

The sequence the appellate court accepted

Longevity Medical Supply, Inc. v Citiwide Auto Leasing, 58 Misc 3d 142(A), was decided December 22, 2017, by the Appellate Term, Second Department. It reversed the order granting the provider summary judgment and denying Citiwide’s motion, granted dismissal and denied the provider’s cross motion.

Before receiving the claim, Citiwide mailed letters scheduling an initial and follow-up IME. The assignor failed to attend. After receiving the claim, Citiwide timely mailed initial and follow-up requests for written verification. Once that material arrived, it timely denied the claim for the missed IMEs. The provider did not raise a triable issue.

The opinion establishes that chronology, but it does not identify a police-report trigger, the exact equipment supplied, or every item requested. Those details should not be added merely because they sound plausible in a no-fault case.

Jason’s original comment

Jason described the pattern this way in December 2017:

This is the famous fact pattern.  Bill is delayed for delayed for verification.  The IME is timely scheduled and there is a double no-show.  Eventual denial comes when the verification is received.  Plaintiff argues that the denial is late because the disclaimer should have been issued when grounds to disclaim existed.  The carrier argues that the bill is tolled until verification is received.  Again, the court held that  a disclaimer is timely when it is issued following receipt of late verification notwithstanding the grounds existing prior,

The repeated words and unfinished punctuation are preserved in the historical quotation. The paragraph is Jason’s commentary on the timing question. The published opinion supplies the operative sequence: the IME letters were sent before this claim arrived, while the written-verification requests followed it.

That distinction avoids presenting the quoted shorthand as if the court had held that an insurer can schedule any examination late while a bill is pending verification.

Alev explains why the last no-show date was not the only date

Longevity cited Alev Medical Supply v New York Central Mutual, 2013 NY Slip Op 50258(U). In Alev, the lower court had rejected denials on two causes of action because they were sent more than forty-five days after the second missed IME.

The Appellate Term reversed. Timely initial and follow-up requests for both IMEs and written verification had tolled the payment-or-denial period. The insurer denied within thirty days after it received the requested written verification. Counting only from the final nonappearance missed that outstanding verification.

Alev therefore provides a concrete companion for the result, not a license to ignore dates. The requests’ timeliness and the subsequent receipt of verification were part of the showing. Its reversal concerned the second and third causes of action identified in that appeal.

Why “all time requirements are tolled” is too broad

The later Burke Physical Therapy v State Farm, 83 Misc 3d 41 (2024), addressed a different record: the provider attended the EUO, and the insurer then requested new written verification. The court held that the prior toll of the time to pay or deny did not extend the separate deadline to request that new verification.

The insurer’s motion failed; the provider’s cross motion also remained denied. This was not a ruling that every verification defense disappears or that every bill must be paid on the initial form alone.

The distinction answers the overstatement in the older expanded copy. Ask which time period is affected, what request created the asserted toll, and whether the response completed that request. Calling a claim “delayed” does not answer those questions.

Follow-up versus a new request

A reminder seeking material already requested is not necessarily the same as an original demand for something different. Burke expressly distinguished those situations. It also distinguished an unfulfilled request from an examination that had actually been completed.

For a file review, keep the original request and each later letter in sequence. Identify what each asks for, when it was sent, and whether the requested material was supplied. Record any response explaining why the recipient cannot provide an item. Those documents make it possible to evaluate the asserted toll rather than infer one from the insurer’s label. A timeline should distinguish the date of a letter from the date the insurer received the requested response. It should also identify whether a later request repeats an outstanding item or asks for something new. Otherwise two quite different reasons for a pending claim can look identical in a billing-system status.

This note does not supply a universal time calculator. It preserves the legal difference that makes a calculation possible: the obligation to seek verification and the time to pay or deny are not interchangeable.

Compare pre-claim IME notices with post-claim verification

Nationwide General v Gaines (2025) is a later First Department example involving IME notices sent before receipt of claims. The court rejected an objection based on post-claim verification notice requirements and treated the established no-show as a coverage defense.

That result and Longevity’s sequence can be read together without saying they announced identical rules. Gaines arose in a different appellate forum and did not require a timely disclaimer. Longevity expressly found the denial timely after written verification.

Acosta supplies the opposite timing comparison: the record did not establish the insurer’s compliance with the applicable examination time frames. The distinction is why a current file should be reviewed by forum and chronology, not by a single phrase such as “IME no-show disclaimer.”

Other proof issues remain separate

Proper timing cannot replace competent evidence that notices were mailed or that the claimant missed the appointments. East 75th Street and Quality Psychological and Arco Medical show accepted evidence for those distinct facts.

Nor does successful no-show proof resolve every procedural issue in a coverage action. Solorzano separates summary relief from default-notice compliance. Preferred Ortho shows an address objection lost at the appellate stage because it was not raised below.

For a reader, these connections supply the next relevant question: is the problem the request, its timing, the evidence of absence, the denial or the relief being sought? Longevity answers one combination of those issues. It should remain a dated, useful example rather than a broad assurance that outstanding verification excuses every delay.

Connect to the Encyclopedia

The IME no-show case directory connects notice, attendance, timing and procedural decisions:

• East 75th Street: the Nassau County examination-notice record
• Acosta: timing proof and the separate Unitrin concurrence
• Quality Psychological and Arco: proof subjects, not an affidavit headcount
• Preferred Ortho: an address objection first raised on appeal
• Solorzano: summary judgment and default relief were different requests

For review of a particular no-fault claim or motion record, contact the Law Office of Jason Tenenbaum, P.C. and read about our no-fault defense practice.