October 8, 2013
Ranbow Supply of N.Y., Inc. v Progressive Northeastern Ins. Co. (2013 NY Slip Op 51729(U))
https://www.beynensonlaw.com/case-law/ranbow-supply-of-n-y-inc-v-progressive-northeastern-ins-co-2013-nyslip-op-51729u/
- Decided
- October 8, 2013
- Citation
- 2013 NY Slip Op 51729(U) · 41 Misc 3d 129(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Legal questions
- Proof of mailing · 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 Ranbow Supply of N.Y., Inc. v Progressive Northeastern Ins. Co. (2013 NY Slip Op 51729(U))
| Ranbow Supply of N.Y., Inc. v Progressive Northeastern Ins. Co. |
| 2013 NY Slip Op 51729(U) [41 Misc 3d 129(A)] |
| Decided on October 8, 2013 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ
2011-186 K C.
against
Progressive Northeastern Insurance Co., Respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Ingrid Joseph, J.), entered August 2, 2010. The order denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.
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 of the Civil Court which denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint, finding that plaintiff’s assignor had failed to appear for duly scheduled independent medical examinations (IMEs).
While plaintiff argues that defendant did not mail its IME scheduling letters to the correct address, defendant sufficiently demonstrated that it addressed the letters to plaintiff’s assignor, defendant’s insured, at the address provided to it by its insured. In addition, defendant demonstrated that copies of the IME scheduling letters had been addressed to, and received by, plaintiff’s assignor’s attorney (see Great Wall Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co., 22 Misc 3d 136[A], 2009 NY Slip Op 50294[U] [App Term, 2d, 11th & 13th Jud Dists 2009]). Plaintiff’s remaining contentions on appeal lack merit.
Accordingly, the order is affirmed.
Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: October 08, 2013
Legal questions (2)
Questions 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 a party’s evidence establish that it mailed a no-fault claim, denial, verification request or examination notice?
This decision: The insurer's (or its agent's) proof established mailing of its denial, verification request or IME/EUO notice
Rejected the wrong-address argument, holding the insurer showed it addressed the IME scheduling letters to the assignor at the address the insured provided, with copies addressed to and received by the assignor's attorney.
Of the 1,400 decisions on this question in the Second Department courts and the Court of Appeals, 809 (this one included) are in the same category.
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
Upheld dismissal on the IME no-show defense because the insurer showed the scheduling letters were sent to the address its insured provided and copies reached the assignor's attorney.
Of the 858 decisions on this question in the Second Department courts and the Court of Appeals, 527 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- Great Wall Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co. (2009 NY Slip Op 50294(U)) FollowedAn EUO governed by amended Regulation 68 must be scheduled within a reasonable time after claim receipt, rather than within 30 days.
Similar decisions
- Ranbow Supply of N.Y., Inc. v NY Cent. Mut. Fire Ins. Co. (2009 NY Slip Op 51083(U))The insurer's inconsistent statements about receipt of the claims defeated its motion for summary judgment based on lack of medical necessity.
- Rainbow Med. Care, P.C. v Kemper Ins. Co. (2012 NY Slip Op 51923(U))The insurer established timely mailing of IME notices and denials and the assignor's failure to appear for the scheduled examinations.
- Rainbow Supply of NY, Inc. v Clarendon Natl. Ins. Co. (2012 NY Slip Op 51489(U))The insurer failed to establish timely denial of the claim and its entitlement to assert the assignor's IME nonappearance.
- Prime Diagnostic Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51523(U))The insurer established proper mailing of IME notices and the denial form, as well as the assignor's failure to attend the IMEs. The provider appealed summary judgment dismissing its assigned no-fault claim.
- Infinity Health Prods., Ltd. v Redland Ins. Co. (2013 NY Slip Op 50751(U))The insurer failed to establish proper IME scheduling because notices used an incorrect ZIP code and counsel's representation was unproved.