Medical provider needs to prove that Assignor was represented by counsel and that counsel failed to receive notification of IME

American Tr. Ins. Co. v Leon, 2013 NY Slip Op 08124 (1st Dept. 2013)

The Law Office of Jason Tenenbaum, P.C., Garden City (Jason
Tenenbaum of counsel), for appellant.

“Order, Supreme Court, New York County (Ellen M. Coin, J.), entered March 26, 2013, which denied plaintiff’s motion for summary judgment, unanimously reversed, on the law, without costs, the motion granted, and it is declared that plaintiff insurance company has no obligation to pay defendant Stand-Up MRI’s claims.

Plaintiff demonstrated its entitlement to judgment as a matter of law by submitting competent evidence that it mailed the notices scheduling the injured defendant’s independent medical examinations (IMEs) and that he failed to appear for the examinations (see American Transit Ins. Co. v. Lucas, __ AD3d __, 2013 NY Slip Op 07273 [1st Dept 2013]; American Tr. Ins. Co. v Solorzano, 108 AD3d 449, 449 [1st Dept 2013]). Defendant provider’s contention that plaintiff failed to prove the mailing of IME notices to the assignor’s attorney, absent competent proof in the record establishing that the assignor was represented by counsel with regard to the subject no-fault claim, is unavailing (see Center for Orthopedic Surgery, LLP v New York Cent. Mut. Fire Ins., 31 Misc 3d 128[A], 2011 N.Y. Slip Op. 50473[U] [App Term 1st Dept 2011]).

Attendance at a medical examination is a condition of coverage. Accordingly, there is no[*2]requirement that the claim denial be timely made (see American Transit Ins. Co. v. Lucas, __ AD3d __, 2013 NY Slip Op 07273; Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559, 560 [1st Dept 2011], lv denied 17 NY3d 705 [2012]).”

By the way, this case now effectively overrules Infinity Health Prods., Ltd. v Redland Ins. Co., 2013 NY Slip Op 50751(U)(App. Term 2d Dept. 2013)(“ Furthermore, there is nothing in the record to suggest that plaintiff’s assignor was represented by the attorney to whom the IME scheduling letters were also sent. Consequently, defendant failed to demonstrate that the IMEs had been properly scheduled.”)

 

Facebook
Twitter
Email
Print
Practice Areas

Our wide-ranging expertise will provide you with well-rounded legal counsel

At the Law Office of Jason Tenenbaum, our attorneys have the integrity and experience you need to best assist, advise, and support you through your legal challenge, every step of the way.

No Fault Defense
Practice Areas
No Fault Defense

Using cutting-edge technology and strategy to solve complicated problems.

Woman in the hospital with injured leg
Practice Areas
Personal Injury

We can fight for your pain and suffering, lost income, medical bills, and any future lost wages.

Upset woman in the front of the computer with bills
Practice Areas
Medical Malpractice

You have the right to bring a malpractice claim for your medical expenses, lost income and pain and suffering.

Card in the hand
Practice Areas
Consumer Protection

If you have been sued for an unpaid consumer loan, fallen behind on your credit card bills or similar.

Court room
Practice Areas
Commercial Litigation

We can help when you are faced with commercial litigation issues.

We dedicate ourselves to important values

We work hard to fight for your individual case and rights, while providing superior legal services on a timely, effective, and efficient basis. 

Need Help With Your Case?

Proin rhoncus metus aliquet blandit ad placerat sociosqu erat vel letius scelerisque taciti pulvinar.

Got Questions?

Proin rhoncus metus aliquet blandit ad placerat sociosqu erat vel letius scelerisque taciti pulvinar.