Unitrin has created this vacuum where the failure to control ones Assignor has spelled unabated doom to many a medical clinic. Imagine having this conversation during that crazy period when the law was “the failure to attend an IME rebuts the presumption of medical necessity?” and the App. Term 1st Dept did everything in the power to avoid ruling on the merits of these cases?
(The commentator Captain America would probably think that it is unconstitutional to demand an innocent Assignor to be deposed and examined in accordance with the insurance policy upon which she is either the NI or the third-party beneficiary)
Dowd v Praetorian Ins. Co., 2012 NY Slip Op 51160(U)(App. Term 1st Dept. 2012)
“The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the action for first-party no-fault benefits by establishing that it timely and properly mailed the notices for independent medical examinations (IMEs) and examinations under oath (EUOs) to plaintiff’s assignor, and that the assignor failed to appear (see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559, 560 [2011]; cf. Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 721 [2006]). In opposition, plaintiff did not specifically deny the assignor’s nonappearance or otherwise raise a triable issue with respect thereto, or as to the mailing or reasonableness of the underlying notices (see Unitrin at 560).”
2 Responses
Note that the Court, citing Unitrin, stated that the IME notices were “timely mailed.” This aspect of the Unitrin decision -requiring timely scheduling of the IME in accordance with the no-fault regulations – is often overlooked.
JT given that I think No Fault is unconstitutional — the corporate-government complex stripping away someone’s rights and forcing them to buy a product that is an obvious ripoff — I would indeed find that anything having to do with No Fault is unconstitutional.
JT tell me why I cannot call in an insurance company exec for an EUO to question him about why my rates are high and why the first questions a claims examiner asks are geared to create a denial justification.
I pay the insurance company money so I should have more rights to an EUO then a poor claimant who has yet to be paid.