Key Takeaway
A routine no-fault insurance case highlights two key defense strategies - EUO non-appearance and staged accident claims - while marking Unitrin's 10th anniversary.
No-fault insurance cases often revolve around procedural defenses that insurers raise to deny claims. Understanding these defenses is crucial for both healthcare providers seeking reimbursement and patients navigating the complex world of New York no-fault insurance law. The recent decision in Impulse Imaging, P.C. v State Farm Fire & Cas. Co. provides a perfect example of how courts handle two of the most common defense strategies.
This case demonstrates the fundamental distinction between defenses that are subject to preclusion (like failure to appear for examinations under oath) and those that are not (such as allegations of staged accidents). While EUOs represent a significant procedural hurdle for claimants, the staged accident defense remains a powerful tool for insurers even when not properly raised initially.
Jason Tenenbaum’s Analysis:
Impulse Imaging, P.C. v State Farm Fire & Cas. Co.. 2021 NY Slip Op 51031(U)(
“In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment. Defendant cross-moved for summary judgment dismissing the complaint on two grounds: (1) that plaintiff’s assignor had failed to appear for examinations under oath (EUOs), a defense which is subject to preclusion (see Westchester Med. Ctr. v Lincoln Gen. Ins. Co., 60 AD3d 1045 ; cf. Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559 ), and (2) that there was a lack of coverage in that the incident from which the alleged injuries arose was a staged accident, a defense which is not subject to preclusion (see Central Gen. Hosp. v Chubb Group of Ins. Cos., 90 NY2d 195 ).”
It is not as if this decision is in any way notable. I would consider this a typical decision except with the caveat that it is the rare time that the Court cites both cases in its order.
But this was Unitrin’s birthday year. Where are the baloons.
Key Takeaway
This decision illustrates the strategic importance of understanding which no-fault defenses are subject to preclusion rules. While insurers must raise certain defenses promptly or lose them forever, allegations of staged accidents can be raised at any time during litigation, making them particularly valuable for insurance companies defending against fraudulent claims.
Common Questions
Frequently Asked Questions
What is New York's no-fault insurance system?
New York's no-fault insurance system requires all drivers to carry Personal Injury Protection (PIP) coverage. This pays for medical expenses and lost wages regardless of who caused the accident, up to policy limits. However, you can only sue for additional damages if you meet the 'serious injury' threshold.
