May 7, 2015
American Tr. Ins. Co. v Jaga Med. Servs., P.C. (2015 NY Slip Op 03925)
https://www.beynensonlaw.com/case-law/american-tr-ins-co-v-jaga-med-servs-p-c-2015-ny-slip-op03925/
- Decided
- May 7, 2015
- Citation
- 2015 NY Slip Op 03925 · 128 AD3d 441
- Posture
- Summary judgment
- Outcome
- Provider prevailed
- Later treatment
- Declined to follow in 1, contrasted (cf., but see) in 6 and followed in 11 later decisions (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 American Tr. Ins. Co. v Jaga Med. Servs., P.C. (2015 NY Slip Op 03925)
| American Tr. Ins. Co. v Jaga Med. Servs., P.C. |
| 2015 NY Slip Op 03925 [128 AD3d 441] |
| May 7, 2015 |
| Appellate Division, First Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| American Transit Insurance Company,
Respondent, v Jaga Medical Services, P.C., et al., Appellants, et al., Defendants. |
The Rybak Firm, PLLC, Brooklyn (Damin J. Toell of counsel), for appellants.
The Law Office of Jason Tenenbaum, P.C., Garden City (Jason Tenenbaum of counsel), for respondent.
Judgment, Supreme Court, Bronx County (John A. Barone, J.), entered July 12, 2013, which, to the extent appealed from, declared that defendants-appellants were not entitled to no-fault benefits as a result of a motor vehicle accident due to the claimant’s failure to appear for scheduled examinations under oath (EUO), unanimously reversed, on the law, without costs, the underlying motion for summary judgment denied, and the judgment vacated.
The reason for the EUO request is a fact essential to justify opposition to plaintiff’s summary judgment motion (see American Tr. Ins. Co. v Curry, 45 Misc 3d 171, 174-175 [Sup Ct, NY County 2013]), and such fact is exclusively within the knowledge and control of the movant. Further discovery on plaintiff’s handling of the claim so as to determine whether, inter alia, the EUOs were timely and properly requested is also essential to justify opposition. Concur—Mazzarelli, J.P., Renwick, Manzanet-Daniels and Clark, JJ.
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 did not show its requests met the regulatory timing, follow-up or justification requirements
Vacated the declaration for the insurer as premature because the reason for the EUO request and whether the EUOs were timely and properly requested were facts within the insurer's exclusive knowledge needing discovery.
Of the 165 decisions on this question in the First Department courts and the Court of Appeals, 39 (this one included) are in the same category. 8 decisions in other departments that cite or are cited by this one are on the full map.
Cited in this decision
A label shows how this decision treated the case it cites.
- American Tr. Ins. Co. v Curry (2013 NY Slip Op 23470) FollowedThe insurer failed to justify its EUO request or offer admissible proof of the injured claimant's nonappearance.
Cited by (20)
A label shows how the later decision treated this one.
- Flatbush Acupuncture P.C. v Repwest Ins. Co. (2025 NY Slip Op 25032) Declined to followAn insurer in the Second Department need not disclose its objective justification for an EUO to obtain summary judgment for nonappearance.
- Palafox PT, P.C. v State Farm Mut. Auto. Ins. Co. (2015 NY Slip Op 51653(U)) Contrasted (cf., but see)The provider failed to identify discovery that could raise a triable issue concerning the insurer's EUO nonappearance defense.
- Vladenn Med. Supply Corp. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50928(U)) Contrasted (cf., but see)The insurer proved timely mailing and the provider's EUO nonappearances, while the provider failed to justify further discovery.
- NY Wellness Med., P.C. v Nationwide Mut. Ins. Co. (2022 NY Slip Op 50359(U)) Contrasted (cf., but see)An insurer need not set forth objective reasons for requesting EUOs to establish prima facie entitlement to summary judgment.
- MUA Chiropractic Healthcare, PLLC v Nationwide Mut. Ins. Co. (2022 NY Slip Op 51384(U)) Contrasted (cf., but see)An insurer need not state objective reasons for provider EUOs to establish prima facie entitlement to summary judgment for nonappearance.
- Park Ave. Chiropractic & Health Care PC v Maya Assur. Co. (2021 NY Slip Op 50804(U)) Contrasted (cf., but see)A provider's EUO objection written after the scheduled examination date is ineffective and does not excuse nonappearance.
- Actual Chiropractic, P.C. v State Farm Ins. (2019 NY Slip Op 50421(U)) Contrasted (cf., but see)An insurer need not state objective reasons for requesting EUOs to establish entitlement to summary judgment for nonappearance.
- Kemper Independence Ins. Co. v AB Med. Supply, Inc. (2020 NY Slip Op 06209) FollowedThe insurer's summary judgment motion was premature because its objective basis for requesting an EUO was unavailable to the providers.
- Country-Wide Ins. Co. v Delacruz (2022 NY Slip Op 03068) FollowedThe insurer's EUO nonappearance motion was premature because it withheld the specific objective justification for requesting the EUO. The Appellate Division, First Department, affirmed denial of summary judgment against the providers under CPLR 3212 (f).
- Kemper Independence Ins. Co. v Accurate Monitoring, LLC (2021 NY Slip Op 21253) FollowedAn insurer must provide specific objective justification for an EUO when the claimant requests it during claims verification.
Show all 20 citing decisions
- Global Liberty Ins. Co. of N.Y. v Acupuncture Now, P.C. (2019 NY Slip Op 08942) Followed
- Country-Wide Ins. Co. v Delacruz (2021 NY Slip Op 21019) Followed
- Country-Wide Ins. Co. v Alicea (2023 NY Slip Op 01474) Followed
- State Farm Mut. Auto. Ins. Co. v Lifeline Med. Imaging, P.C. (2025 NY Slip Op 02025) Followed
- Avalon Radiology, P.C. v Ameriprise Ins. Co. (2016 NY Slip Op 26182) Followed
- State Farm Mut. Auto. Ins. Co. v Sweetwater Chiropractic, P.C. (2018 NY Slip Op 51177(U)) Followed
- Sure Way NY, Inc. v Travelers Ins. Co. (2016 NY Slip Op 26413) Followed
- Country-Wide Ins. Co. v Henderson (2022 NY Slip Op 51304(U)) Followed
- 360 Wellness PT PLLC v State Farm Ins. Co. (2026 NY Slip Op 26206)
- Kim v State Farm Ins. Co. (2024 NY Slip Op 51364(U))
Similar decisions
- Active Care Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50767(U))The insurer's motion for summary judgment dismissing the provider's complaint based on EUO nonappearance was granted.
- Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2019 NY Slip Op 50744(U))An insurer need not state objective reasons for requesting EUOs to obtain summary judgment based on a provider's nonappearance.
- A.B. Med. Servs., PLLC v American Tr. Ins. Co. (2009 NY Slip Op 52067(U))The insurer established mailing of the EUO notices and the assignor's failure to appear, warranting dismissal of the providers' claims.
- A.C. Med., P.C. v Ameriprise Ins. Co. (2020 NY Slip Op 51376(U))The insurer's summary judgment motion based on EUO nonappearance was denied because timely denials were not established.
- Greenway Med. Supply Corp. v American Tr. Ins. Co. (2017 NY Slip Op 51901(U))The insurer's summary judgment dismissal for the provider's EUO nonappearance was affirmed.