Key Takeaway
Court rules insurance company failed to provide adequate IME notice when letter to insured was sent to wrong address, despite proper notice to attorney.
Proper Notice Requirements for Independent Medical Examinations
In New York no-fault insurance cases, insurance companies must provide adequate notice when scheduling Independent Medical Examinations (IMEs). A recent First Department decision highlights the critical importance of ensuring that IME scheduling letters reach the insured person directly, even when their attorney is also notified.
The case Global Liberty Ins. Co. v New Century Acupuncture, P.C. demonstrates how technical mailing errors can derail an insurance company’s efforts to deny coverage based on an IME no-show. This decision underscores the rigorous notice standards that courts apply when evaluating whether an insured person’s failure to appear at an IME justifies claim denial.
Understanding these notice requirements is essential for both insurance companies and healthcare providers navigating New York No-Fault Insurance Law. Similar IME notice issues frequently arise in no-fault litigation, as seen in cases involving mailing problems that prevent proper IME scheduling.
Jason Tenenbaum’s Analysis:
Global Liberty Ins. Co. v New Century Acupuncture, P.C., 2018 NY Slip Op 03444 (1st Dept. 2018)
“Plaintiff sent an initial IME scheduling letter, and a re-scheduling letter, to both Davis and her attorney. After Davis failed to appear for the re-scheduled IME, plaintiff sent a third letter to the attorney, which indicated on its face that a copy had been sent to Davis. However, it is undisputed that the letter to Davis was sent to the wrong address. Thus, there was no reason for the attorney to know that Davis had not received notice of the re-scheduled IME and to tell her of the new IME date and location. Under these circumstances, the motion court properly found that plaintiff failed to demonstrate that it provided adequate notice, reasonably calculated to apprise Davis that her appearance at an IME at a specified date and location was required”
Key Takeaway
Courts require insurance companies to provide actual notice to insured persons for IME scheduling, not just notice to their attorneys. When an IME letter is sent to the wrong address, the insurance company cannot rely on attorney notification alone to establish adequate notice, even if the attorney received proper notice and had no reason to know the insured wasn’t notified.
