December 8, 2017
Renelique Med. Servs., P.C. v Travelers Ins. Co. (2017 NY Slip Op 51728(U))
https://www.beynensonlaw.com/case-law/renelique-med-servs-p-c-v-travelers-ins-co-2017-ny-slip-op51728u/
- Decided
- December 8, 2017
- Citation
- 2017 NY Slip Op 51728(U) · 58 Misc 3d 128(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
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 Renelique Med. Servs., P.C. v Travelers Ins. Co. (2017 NY Slip Op 51728(U))
| Renelique Med. Servs., P.C. v Travelers Ins. Co. |
| 2017 NY Slip Op 51728(U) [58 Misc 3d 128(A)] |
| Decided on December 8, 2017 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports.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 December 8, 2017
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th
JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, MARTIN M.
SOLOMON, JJ
2014-2629 K C
against
Travelers Insurance Co., Respondent.
Kopelevich & Feldsherova, P.C. (Galina Feldsherova, Esq.), for appellant. Law Offices of Aloy O. Ibuzor (Gregory W. Broido, Esq.), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Shears, J.), entered October 3, 2014. The order granted defendant’s 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 granted defendant’s motion for summary judgment dismissing the complaint.
Contrary to plaintiff’s arguments on appeal, defendant established that plaintiff had failed to appear for properly scheduled examinations under oath (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]) and that the claims had been timely denied on that ground (see Arco Med. NY, P.C. v Lancer Ins. Co., 34 Misc 3d 134[A], 2011 NY Slip Op 52382[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]).
Accordingly, the order is affirmed.
PESCE, P.J., ALIOTTA and SOLOMON, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: December 08, 2017
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 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 established that the provider failed to appear for properly scheduled examinations under oath, rejecting the provider's arguments on appeal.
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.
Is an IME/EUO no-show defense precluded if the insurer did not timely deny the claim on that ground?
This decision: Timely denial required as part of the no-show defense, and the insurer showed it (rules on the question, but another ground decided the case)
Held the insurer established, as part of its EUO no-show defense, that the claims had been timely denied on that ground.
Of the 500 decisions on this question in the Second Department courts and the Court of Appeals, 334 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co. (2006 NY Slip Op 09604) FollowedAn insurer may deny benefits retroactively to the date of loss for failure to attend reasonably required IMEs under 11 NYCRR 65-1.1.
- ARCO Med. N.Y., P.C. v Lancer Ins. Co. (2011 NY Slip Op 52382(U)) FollowedA follow-up EUO request is not premature when sent within 10 days after failure to appear for the initial scheduled examination.
Similar decisions
- Pierre J. Renelique, M.D., P.C. v Travelers Ins. Co. (2017 NY Slip Op 51718(U))The insurer's summary judgment motion based on EUO nonappearance was granted as to the first and fourth through seventh causes of action.
- Renelique Med. Servs., P.C. v State Farm Fire & Cas. Co. (2017 NY Slip Op 50163(U))The insurer's attorney affirmation based on personal knowledge established the provider's failure to attend scheduled EUOs. The insurer sought summary judgment dismissing the assigned no-fault claims, supporting its motion with a law-firm partner's affirmation attesting to the nonappearances.
- Allay Med. Servs., P.C. v Travelers Ins. Co. (2019 NY Slip Op 51806(U))The insurer established timely mailing of EUO scheduling letters and the denial, together with nonappearance at the scheduled EUOs. The provider appealed an order granting the insurer summary judgment dismissing the complaint and denying the provider's cross motion for summary judgment in an assigned no-fault action.
- Renelique v Utica Mut. Ins. Co. (2016 NY Slip Op 51530(U))The insurer failed to establish a timely EUO request where its first scheduling letter was sent 35 days after receipt of the claim.
- Compas Med., P.C. v Travelers Ins. Co. (2015 NY Slip Op 51568(U))The insurer's attorney failed to establish the provider's nonappearance at both scheduled EUOs through personal knowledge or other proper proof.