June 10, 2022
Columbus Imaging Ctr., LLC v Erie Ins. Co. of N.Y. (2022 NY Slip Op 50569(U))
https://www.beynensonlaw.com/case-law/columbus-imaging-ctr-llc-v-erie-ins-co-of-n-y-2022-ny-slip-op50569u/
- Decided
- June 10, 2022
- Citation
- 2022 NY Slip Op 50569(U) · 75 Misc 3d 137(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Later treatment
- Followed in 1 later decision (see Cited by)
- Legal questions
- No-show defense: insurer's proof (see the maps)
Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.
Summary
Editorial summary by Beynenson Law, not part of the court’s decision.
Reported in New York Official Reports at Columbus Imaging Ctr., LLC v Erie Ins. Co. of N.Y. (2022 NY Slip Op 50569(U))
| Columbus Imaging Ctr., LLC v Erie Ins. Co. of N.Y. |
| 2022 NY Slip Op 50569(U) [75 Misc 3d 137(A)] |
| Decided on June 10, 2022 |
| Appellate Term, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Decided on June 10, 2022
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : THOMAS P. ALIOTTA, P.J., WAVNY TOUSSAINT, DONNA-MARIE E. GOLIA, JJ
2020-73 K C
against
Erie Insurance Company of New York, Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Law Office of Robyn M. Brilliant (Robyn M. Brilliant of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered September 27, 2019. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order granting defendant’s motion for summary judgment dismissing the complaint and denying plaintiff’s cross motion for summary judgment.
Contrary to plaintiff’s sole contention on appeal with respect to defendant’s motion for summary judgment, defendant did not need to demonstrate, as part of its prima facie case, that the first independent medical examination scheduling letter had been sent to plaintiff’s assignor within 15 days of defendant’s receipt of either the NF-2 or a claim received from another provider (see City Anesthesia Healthcare, P.C. v Erie Ins. Co. of NY, 70 Misc 3d 141[A], 2021 NY Slip Op 50135[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]; 11 NYCRR 65-3.5 [b]; Appendix 13; see also State Farm Mut. Auto. Ins. Co. v Surgicore of Jersey City, LLC, 195 AD3d 454 [2021]; Excel Prods., Inc. v Ameriprise Auto & Home, 71 Misc 3d 136[A], 2021 NY Slip Op 50435[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]).
Accordingly, the order is affirmed.
ALIOTTA, P.J., TOUSSAINT and GOLIA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 10, 2022
Legal questions
A question of no-fault law this decision rules on, from our Legal Questions pages. Bars count the decisions on the question by year and court, coloured by category; circles are this decision and the decisions on the question it cites or that cite it. Point at a bar or circle for details. The categories and summaries are Beynenson Law’s classification, made by a language model and checked by a second reading.
Did the insurer prove its IME/EUO no-show defense: mailed, compliant scheduling requests and the claimant’s nonappearance?
This decision: Insurer proved mailed, compliant requests and the nonappearance; claimant's answers rejected
Held the insurer did not have to show, as part of its prima facie IME no-show case, that the first scheduling letter was sent within 15 days of receiving the NF-2 or another provider's claim.
Of the 851 decisions on this question in the Second Department courts and the Court of Appeals, 525 (this one included) are in the same category. One decision in other departments that cites or is cited by this one is on the full map.
Cited in this decision
- City Anesthesia Healthcare, P.C. v Erie Ins. Co. of N.Y. (2021 NY Slip Op 50135(U))A pre-claim IME scheduling letter need not be mailed within 30 days after the insurer receives the NF-2.
- State Farm Mut. Auto. Ins. Co. v Surgicore of Jersey City, LLC (2021 NY Slip Op 03536)The insurer established entitlement to a default declaration of noncoverage based on a founded belief that the collision was staged.
Cited by
A label shows how the later decision treated this one.
- Wellness Plaza Acupuncture, P.C. v Nationwide Ins. (2022 NY Slip Op 50934(U)) FollowedThe insurer established timely mailing of EUO notices and denials, and the provider raised no factual issue concerning mailing timeliness.
Similar decisions
- Columbus Imaging Ctr., LLC v National Liab. & Fire Ins. Co. (2022 NY Slip Op 50556(U))The insurer's affidavit failed to establish proper addressing and timely mailing of the IME scheduling letters.
- Columbus Imaging Ctr., LLC v Nationwide Ins. (2022 NY Slip Op 50620(U))The insurer's doctors failed to establish personal knowledge of the assignor's IME nonappearances, defeating summary judgment on that defense.
- Metropolitan Surgical Servs., P.C. v 21st Century Ins. Co. (2022 NY Slip Op 50606(U))An insurer need not comply with 11 NYCRR 65-3.6 (b) for IMEs scheduled before it receives the claim at issue.
- MSB Physical Therapy, P.C. v Nationwide Ins. (2022 NY Slip Op 50564(U))An insurer need not prove that its first EUO scheduling letter was sent within 15 days of receiving an NF-2 or another provider's claim.
- Sheepshead Bay Med. Supply, Inc. v Erie Ins. Co. of N.Y. (2021 NY Slip Op 50491(U))Outdated denial forms are not fatally defective when they contain substantially the same pertinent information as the prescribed form.