From Casetext: Smarter Legal Research

Am. Transit Ins. Co. v. Leon

Supreme Court, Appellate Division, First Department, New York.
Dec 5, 2013
112 A.D.3d 441 (N.Y. App. Div. 2013)

Opinion

2013-12-5

AMERICAN TRANSIT INSURANCE COMPANY, Plaintiff–Appellant, v. Pablo LEON, et al., Defendants, Stand–Up MRI of Bensonhurst, P.C., Defendant–Appellant.


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, 111 A.D.3d 423, 974 N.Y.S.2d 388, 2013 N.Y. Slip Op. 07273 [1st Dept.2013]; American Tr. Ins. Co. v. Solorzano, 108 A.D.3d 449, 449, 968 N.Y.S.2d 372 [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), 2011 WL 1135952 [App.Term. 1st Dept.2011] ).

Attendance at a medical examination is a condition of coverage. Accordingly, there is no requirement that the claim denial be timely made ( see American Transit Ins. Co. v. Lucas, 111 A.D.3d 423, 974 N.Y.S.2d 388 ; Unitrin Advantage Ins. Co. v. Bayshore Physical Therapy, PLLC, 82 A.D.3d 559, 560, 918 N.Y.S.2d 473 [1st Dept.2011], lv. denied17 N.Y.3d 705, 2011 WL 2535157 [2012] ). MAZZARELLI, J.P., SWEENY, DeGRASSE, FREEDMAN, GISCHE, JJ., concur.


Summaries of

Am. Transit Ins. Co. v. Leon

Supreme Court, Appellate Division, First Department, New York.
Dec 5, 2013
112 A.D.3d 441 (N.Y. App. Div. 2013)
Case details for

Am. Transit Ins. Co. v. Leon

Case Details

Full title:AMERICAN TRANSIT INSURANCE COMPANY, Plaintiff–Appellant, v. Pablo LEON, et…

Court:Supreme Court, Appellate Division, First Department, New York.

Date published: Dec 5, 2013

Citations

112 A.D.3d 441 (N.Y. App. Div. 2013)
2013 N.Y. Slip Op. 8124
975 N.Y.S.2d 875

Citing Cases

Unitrin Advantage Ins. Co. v. Better Health Care Chiropractic, P.C.

Plaintiff need not establish that it timely denied defendants' claims, since a timely denial is not required.…

RepWest Ins. Co. v. Active Care Med. Supply Corp.

To establish that a defendant failed to appear for IMEs, plaintiff must prove that it requested IMEs — by…