Is an IME/EUO no-show defense precluded if the insurer did not timely deny the claim on that ground?

Deciding this question means the court rules whether an insurer's defense that the injured person or provider failed to appear for (or walked out of) a scheduled IME or EUO survives an untimely, defective, unproven or missing denial. Either the court treats the no-show as a breach of a condition precedent to coverage that lets the insurer deny retroactively regardless of the timeliness of its denial (the First Department rule), or it treats the no-show defense as subject to the 30-day pay-or-deny rule and the preclusion remedy, so that the insurer must show a timely and proper denial on that ground (the Second and Fourth Department rule). A decision that applies the second rule, by requiring the insurer to establish a timely denial as part of its no-show defense and ruling on whether it did, decides the question just as a decision that announces the rule does.

The departments are split. The First Department holds that an IME/EUO no-show is a breach of a condition precedent to coverage within the Central General Hospital v Chubb exception, so the insurer need not show a timely denial (Unitrin 2011, applied to EUOs in Allstate v Pierre 2014, repeated through Equinox 2024 and Gaines 2025). The Second Department held in Westchester Med. Ctr. v Lincoln Gen. (2009) that a denial based on an EUO no-show 'was subject to the preclusion remedy'; its later decisions make a timely denial part of the insurer's prima facie case (Interboro v Clennon 2014, Nationwide Affinity v George 2020, Quality Health v Nationwide 2023) and in 2022 called the contrary (coverage) view 'irrational' (Matter of Advanced Orthopaedics). The Fourth Department in Nationwide Affinity v Jamaica Wellness (2018) expressly disagreed with the First Department and held the defense subject to preclusion. The Court of Appeals has not decided the question: the database shows leave denied in Unitrin (17 NY3d 705) and in Westchester (13 NY3d 714); its general framework is Fair Price (2008) and Central General Hospital (1997).

Leading authorities · Authority map · Decisions by court · Plain-text version (Markdown)

Leading authorities

Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC (2011 NY Slip Op 01948) Appellate Division, First Department, 2011First Department: no-show is a coverage defense; timely denial unnecessaryAn assignor's failure to appear for IMEs breaches a condition precedent to coverage and fits the Central General Hospital v Chubb exception to preclusion, so the insurer could deny all claims retroactively to the date of loss even though it had first denied them for lack of medical necessity and regardless of the timeliness of the denials.
Accordingly, when defendants’ assignors failed to appear for the requested IMEs, plaintiff had the right to deny all claims retroactively to the date of loss, regardless of whether the denials were timely issued
Later history: Leave to appeal denied, 17 NY3d 705 (2011), as cited by many later decisions in the database. The Supreme Court order (2010 NY Slip Op 31936[U]) is not in the database. Extended to EUOs by Allstate Ins. Co. v Pierre (6046, 2014). The Fourth Department expressly declined to follow it in Jamaica Wellness (3810, 2018).
Westchester Med. Ctr. v Lincoln Gen. Ins. Co. (2009 NY Slip Op 02589) Appellate Division, Second Department, 2009Second Department: EUO no-show denial is subject to preclusionIn a hospital's action, the insurer's letters holding the claim pending investigation, including EUOs, did not toll the 30 days; a denial based on the assignor's failure to appear for an EUO is a breach of a policy condition, not a lack of coverage, and was subject to the preclusion remedy.
Where, as here, the defendant’s denial of liability also was based upon an alleged breach of a policy condition, to wit, the failure of the plaintiff’s assignor to appear at an examination under oath, such an alleged breach does not serve to vitiate the medical provider’s right to recover no fault benefits or to toll the 30-day statutory period
Later history: Leave to appeal denied, 13 NY3d 714 (2009), as cited in Jamaica Wellness (3810) and Appellate Term decisions. Same case later: Westchester Med. Ctr. v Lincoln Gen. Ins. Co. (7554, 2d Dept 2011) affirmed denial of the insurer's CPLR 5015 motion to modify the judgment. Relied on by the Fourth Department in Jamaica Wellness (3810) and by the Second Department in Matter of Advanced Orthopaedics (2019, 2022).
Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med., P.C. (2018 NY Slip Op 07850) Appellate Division, Fourth Department, 2018Fourth Department rejects Unitrin: no-show defense subject to preclusionA defense based on nonappearance at an EUO is a breach of an existing policy condition (a condition precedent to the insurer's duty to pay, not to the existence of coverage), so it is subject to preclusion; the insurer had to establish timely denials on that ground and its conclusory affidavit without the denial forms did not.
In this appeal, we must determine whether an insurer in a no-fault benefits case may be precluded from asserting a defense premised upon the failure of the insured or that person’s assignee to appear at an examination under oath (EUO) where the insurer has not timely denied coverage. We hold that such a defense is subject to preclusion.
Later history: Reversed Supreme Court (2017 NY Slip Op 32943[U], not in the database). Second appeal in the same case, Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med. (2607, 4th Dept 2020): insurer granted summary judgment after proving timely denials; applied the same day in Nationwide Affinity v PFJ Med. Care (2605). No Court of Appeals history found in the database.
Matter of Advanced Orthopaedics, PLLC v Country-Wide Ins. Co. (2022 NY Slip Op 02406) Appellate Division, Second Department, 2022Second Department: treating no-show as coverage defense is irrationalOn CPLR article 75 review, a master arbitrator's ruling that an EUO no-show is a lack-of-coverage defense not subject to preclusion was irrational; an initial EUO request sent more than 30 days after receipt of the claim is a nullity and is not excused by 11 NYCRR 65-3.5 (p).
The master arbitrator’s determination that a denial of liability based upon a failure to appear at an examination under oath constitutes a defense of lack of coverage, which is not subject to preclusion, is irrational
American Tr. Ins. Co. v Lucas (2013 NY Slip Op 07273) Appellate Division, First Department, 2013First Department: no need to show timely disclaimerIn a declaratory judgment action on IME no-shows, the insurer did not have to show that it timely disclaimed, because the failure to attend the exams voids the policy ab initio and is an absolute coverage defense.
There is no requirement to demonstrate that the claims were timely disclaimed since the failure to attend medical exams was an absolute coverage defense
Later history: Followed for this sentence in Mapfre Ins. Co. of N.Y. v Manoo (5182, 2016), Hereford Ins. Co. v Lida's Med. Supply (3826, 2018) and Nationwide Gen. Ins. Co. v Gaines (11520, 2025).
Interboro Ins. Co. v Clennon (2014 NY Slip Op 00092) Appellate Division, Second Department, 2014Second Department: timely denial is an element of the defenseThe insurer was entitled to a declaration of no obligation to pay because it showed that it twice duly demanded an EUO, that the assignor twice failed to appear, and that it issued a timely denial of the claims; the failure to submit to an EUO is a material breach precluding recovery of policy proceeds.
Here, the plaintiff insurer established as a matter of law that it twice duly demanded an examination under oath from the appellants’ assignor, who had allegedly been injured in a motor vehicle accident, that the assignor twice failed to appear, and that the plaintiff issued a timely denial of the claims arising from the appellants’ treatment of the assignor.
Later history: None found. Followed in IDS Prop. Cas. Ins. Co. v Stracar Med. Servs. (6068, 2014), Nationwide Affinity Ins. Co. of Am. v George (2599, 2020) and Quality Health Supply Corp. v Nationwide Ins. (1660, 2023).
Central Gen. Hosp. v Chubb Group of Ins. Cos. 90 NY2d 195Narrow lack-of-coverage exception to preclusion; Unitrin places IME no-shows within it, Westchester and Jamaica Wellness do not.Not in our database.
Presbyterian Hosp. in City of N.Y. v Maryland Cas. Co. 90 NY2d 274General preclusion rule for defenses not raised in a timely denial.Not in our database.
Matter of Acuhealth Acupuncture, P.C. v Country-Wide Ins. Co. 170 AD3d 1168Cited by Matter of Advanced Orthopaedics (2022) for holding irrational a master arbitrator's ruling that an EUO no-show defense is not subject to preclusion; not in the database, so its exact holding is known only from that citation.Not in our database.
PV Holding Corp. v Hank Ross Med., P.C. 188 AD3d 429Cited by State Farm v Equinox (2024): because the policy is vitiated by the EUO no-show, the insurer need not establish a timely denial. Not in the database.Not in our database.
PV Holding Corp. v AB Quality Health Supply Corp. 189 AD3d 645Cited by Unitrin v Dowd (2021): the no-show coverage defense applies to all claims, not bill by bill. Not in the database.Not in our database.
Argento v Aetna Cas. & Sur. Co. 184 AD2d 487Source of the Second Department statement that failure to submit to an EUO is a material breach precluding recovery of policy proceeds (quoted in Clennon and George).Not in our database.
Ops Gen Counsel NY Ins Dept No. 03-02-12 Insurance Department General Counsel opinion, Feb. 2003On the effect of a failure to attend an IME on pending and future claims; relied on in Stephen Fogel (2d Dept 2006) and the dissent in American Tr. v Longevity (1st Dept 2015).Not in our database.

Authority map

Each circle is a decision on this question, placed by court and date; its colour is the position it took. Lines are citations between them. Select a circle (or find a decision by name) to see its links and summary. The same decisions are listed by court below the map.

No-show voids coverage; insurer need not show a timely denialNo-show defense is subject to preclusion and fails for want of a timely, proper denialTimely denial required as part of the no-show defense, and the insurer showed itRing: rules on the question, but another ground decided the caseContrasted, distinguished or limitedDeclined to follow, questioned, overruled or reversedCited Show ordinary citations

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Position by court

Court	Coverage defense	Precludable: denial lacking	Precludable: denial timely	Total
Appellate Division, First Department	12	1	0	13
Appellate Division, Second Department	0	3	4	7
Appellate Division, Fourth Department	0	1	2	3
Appellate Term, First Department	12	0	0	12
Appellate Term, Second Department	0	125	279	404
Trial courts in the First Department	6	1	3	10
Trial courts in the Second Department	4	17	25	46

Decisions (495)

Every decision in our database that rules on this question: highest court first, then by department, newest first. 204 turn on it; the others rule on it alongside a different main ground (marked "also decides"). The one-sentence summaries describe what each court said on this question.

Appellate Division, First Department (13 decisions)

Nationwide Gen. Ins. Co. v Gaines (2025 NY Slip Op 01896) Appellate Division, First Department, April 1, 2025No-show voids coverage; insurer need not show a timely denial (also decides)Held the insurers were not required to establish a timely disclaimer because the claimant's failure to attend properly noticed IMEs forecloses coverage.
State Farm Mut. Auto. Ins. Co. v Equinox Physical Therapy, P.C. (2024 NY Slip Op 05193) Appellate Division, First Department, October 22, 2024No-show voids coverage; insurer need not show a timely denial (also decides)Held that because the EUO no-shows vitiated the policy, the insurer did not have to establish that it timely denied the claims.
Unitrin Advantage Ins. Co. v Dowd (2021 NY Slip Op 03012) Appellate Division, First Department, May 11, 2021No-show voids coverage; insurer need not show a timely denialHeld that the provider's failure to appear for a timely requested EUO voided the policy ab initio, so the insurer could deny all claims retroactively regardless of whether the denials were timely, not bill by bill.
Kemper Independence Ins. Co. v Cornerstone Chiropractic, P.C. (2020 NY Slip Op 03876) Appellate Division, First Department, July 9, 2020No-show voids coverage; insurer need not show a timely denial (also decides)Declared the providers not entitled to benefits, granting summary judgment on the EUO no-show ground as an additional ground, even though the insurer had not proved proper delivery of its denials.
Matter of Global Liberty Ins. Co. of N.Y. v Top Q. Inc. (2019 NY Slip Op 06445) Appellate Division, First Department, September 3, 2019No-show voids coverage; insurer need not show a timely denialVacated a master arbitrator's award as irrational because it ignored the controlling rule that the assignor's failure to attend scheduled IMEs rendered the policy void ab initio.
Hereford Ins. Co. v Lida's Med. Supply, Inc. (2018 NY Slip Op 03226) Appellate Division, First Department, May 3, 2018No-show voids coverage; insurer need not show a timely denial (also decides)Held the insurer did not need to show the claims were timely disclaimed because the claimants' failure to attend IMEs was an absolute coverage defense.
Unitrin Advantage Ins. Co. v All of NY, Inc. (2018 NY Slip Op 00810) Appellate Division, First Department, February 6, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialFor two bills with timely EUO requests, held the defense failed because the denial form cited only the first EUO nonappearance and so did not adequately apprise the provider of the ground.
Mapfre Ins. Co. of N.Y. v Manoo (2016 NY Slip Op 04446) Appellate Division, First Department, June 9, 2016No-show voids coverage; insurer need not show a timely denial (also decides)Held the EUO no-show a breach of a condition precedent vitiating coverage, so the insurer had no requirement to show the claims were timely disclaimed because nonattendance was an absolute coverage defense.

Show all 13 decisions

Matter of Global Liberty Ins. Co. v Professional Chiropractic Care, P.C. (2016 NY Slip Op 04156) Appellate Division, First Department, May 31, 2016No-show voids coverage; insurer need not show a timely denialVacated as arbitrary a master arbitrator's award that ignored the rule that the assignor's IME no-show voided the policy ab initio, holding the alleged error in the denial form of no moment.
Allstate Ins. Co. v Pierre (2014 NY Slip Op 08921) Appellate Division, First Department, December 23, 2014No-show voids coverage; insurer need not show a timely denialHeld that the rule that an exam no-show voids coverage regardless of the denial's timeliness applies to EUOs, and rejected as unpreserved and unavailing the argument that the insurer waived the defense by not proving a denial.
American Tr. Ins. Co. v Leon (2013 NY Slip Op 08124) Appellate Division, First Department, December 5, 2013No-show voids coverage; insurer need not show a timely denial (also decides)Held that because attendance at a medical examination is a condition of coverage, the insurer did not have to show the claim denial was timely made.
American Tr. Ins. Co. v Lucas (2013 NY Slip Op 07273) Leading case Appellate Division, First Department, November 7, 2013No-show voids coverage; insurer need not show a timely denialHeld the failure to attend duly scheduled exams voids the policy ab initio, so the insurer could deny all claims retroactively regardless of whether denials were timely and need not show timely disclaimer.
Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC (2011 NY Slip Op 01948) Leading case Appellate Division, First Department, March 17, 2011No-show voids coverage; insurer need not show a timely denialHeld IME nonappearance breached a condition precedent to coverage within the preclusion exception, so the insurer could deny all claims retroactively regardless of whether the denials were timely or first based on medical necessity.

Appellate Division, Second Department (7 decisions)

Quality Health Supply Corp. v Nationwide Ins. (2023 NY Slip Op 02689) Appellate Division, Second Department, May 17, 2023Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer issued a timely and proper denial following the insured's failure to appear at the last of three scheduled EUOs, so its no-show defense was established.
Matter of Advanced Orthopaedics, PLLC v Country-Wide Ins. Co. (2022 NY Slip Op 02406) Leading case Appellate Division, Second Department, April 13, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld irrational a master arbitrator's ruling that an EUO no-show is a non-precludable lack-of-coverage defense, and held an initial EUO request sent over 30 days after the claim a nullity not excused by 65-3.5 (p).
Nationwide Affinity Ins. Co. of Am. v George (2020 NY Slip Op 02801) Appellate Division, Second Department, May 13, 2020Timely denial required as part of the no-show defense, and the insurer showed itRequired a timely and proper denial as an element of the EUO no-show defense and found the denials, mailed within 30 days of the second scheduled EUO, timely; the providers' affidavits did not contradict the mailing practice.
Progressive Cas. Ins. Co. v Infinite Ortho Prods., Inc. (2015 NY Slip Op 03340) Appellate Division, Second Department, April 22, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurers not entitled to a declaration of no coverage on their EUO no-show and verification grounds because they failed to prove timely and proper mailing of the denials.
IDS Prop. Cas. Ins. Co. v Stracar Med. Servs., P.C. (2014 NY Slip Op 02902) Appellate Division, Second Department, April 30, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established its no-show defense by showing two EUO demands, two nonappearances and a timely denial of the claims.
Interboro Ins. Co. v Clennon (2014 NY Slip Op 00092) Leading case Appellate Division, Second Department, January 8, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to a no-coverage declaration because it established two duly demanded EUOs, two nonappearances and a timely denial of the claims.
Westchester Med. Ctr. v Lincoln Gen. Ins. Co. (2009 NY Slip Op 02589) Leading case Appellate Division, Second Department, March 31, 2009No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the denial based on the assignor's EUO no-show was a breach of a policy condition, not lack of coverage, and was precluded because investigation letters did not toll the 30 days.

Appellate Division, Fourth Department (3 decisions)

Nationwide Affinity Ins. Co. of Am. v PFJ Med. Care, P.C. (2020 NY Slip Op 00972) Appellate Division, Fourth Department, February 7, 2020Timely denial required as part of the no-show defense, and the insurer showed itApplied the rule that an EUO no-show defense is subject to preclusion, granted renewal so the insurers could submit their denial forms, and held they met their burden including timely and proper denials.
Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med., P.C. (2020 NY Slip Op 00971) Appellate Division, Fourth Department, February 7, 2020Timely denial required as part of the no-show defense, and the insurer showed itApplied the rule that an EUO no-show defense is subject to preclusion and held that the insurers, now submitting the denial forms and detailed affidavits, met their burden including timely denials.
Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med., P.C. (2018 NY Slip Op 07850) Leading case Appellate Division, Fourth Department, November 16, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show defense is a breach of an existing policy condition subject to preclusion, so the insurer had to prove timely denials, and its conclusory affidavit without the denial forms did not.

Appellate Term, First Department (12 decisions)

Vladenn Med. Supply, Corp. v American Commerce Ins. Co. (2016 NY Slip Op 50775(U)) Appellate Term, First Department, May 17, 2016No-show voids coverage; insurer need not show a timely denial (also decides)Rejected the motion court's untimely-denial conclusion, stating that the EUO no-show defense may be asserted regardless of the timeliness of the denial.
Life Tree Acupuncture P.C. v Republic W. Ins. Co. (2016 NY Slip Op 50023(U)) Appellate Term, First Department, January 13, 2016No-show voids coverage; insurer need not show a timely denial (also decides)Held that upon the assignor's failure to appear for IMEs the insurer could deny all claims retroactively to the date of loss regardless of whether the denials were timely, even though some were first denied on other grounds.
Alfa Med. Supplies, Inc. v Praetorian Ins. Co. (2015 NY Slip Op 51847(U)) Appellate Term, First Department, December 18, 2015No-show voids coverage; insurer need not show a timely denial (also decides)Held that once the assignor failed to appear for IMEs the insurer could deny all claims retroactively regardless of whether the denials were timely issued, even though it first denied them on different grounds.
Acupuncture Pain Mgt., P.C. v Kemper Cas. Ins. Co. (2015 NY Slip Op 51522(U)) Appellate Term, First Department, October 20, 2015No-show voids coverage; insurer need not show a timely denial (also decides)Held that upon the assignor's failure to appear for IMEs the insurer could deny all claims retroactively regardless of whether the denials were timely, even though some were first denied on other grounds.
MRJA Radiology, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51381(U)) Appellate Term, First Department, September 29, 2015No-show voids coverage; insurer need not show a timely denial (also decides)Held that the assignor's failure to appear for IMEs let the insurer deny all claims retroactively regardless of whether the denials were timely, even though it initially denied them on other grounds.
21st Century Acupuncture, P.C. v Allstate Ins. Co. (2015 NY Slip Op 50445(U)) Appellate Term, First Department, April 2, 2015No-show voids coverage; insurer need not show a timely denial (also decides)Held that on the assignor's failure to appear for the acupuncture IME the insurer could deny all claims retroactively regardless of whether the denials were timely, even though some were first denied on other grounds.
Acupuncture Solutions, P.C. v Lumbermans Mut. Cas. Co. (2015 NY Slip Op 50346(U)) Appellate Term, First Department, March 23, 2015No-show voids coverage; insurer need not show a timely denial (also decides)Held that after the assignor's IME no-show the insurer could deny all claims retroactively to the date of loss regardless of whether the denials were timely issued and despite initially denying some on other grounds.
River Acupuncture, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 50271(U)) Appellate Term, First Department, March 4, 2015No-show voids coverage; insurer need not show a timely denial (also decides)Held that after the assignor's IME nonappearance the insurer could deny all claims retroactively regardless of whether the denials were timely issued and even though it first denied on other grounds.

Show all 12 decisions

Alpha Acupuncture, P.C. v Hertz Claim Mgt. Corp. (2014 NY Slip Op 51515(U)) Appellate Term, First Department, October 22, 2014No-show voids coverage; insurer need not show a timely denial (also decides)Held that after the IME no-show the insurer could deny all claims retroactively to the date of loss regardless of whether the denials were timely, even though it first denied on other grounds.
Healthy Way Acupuncture, P.C. v Allstate Ins. Co. (2014 NY Slip Op 50841(U)) Appellate Term, First Department, May 30, 2014No-show voids coverage; insurer need not show a timely denial (also decides)Held that after the IME no-shows the insurer could deny all claims retroactively regardless of whether the denials were timely issued and even though it first denied on other grounds.
Stracar Med. Servs. v New York Cent. Mut. Ins. Co. (2014 NY Slip Op 50263(U)) Appellate Term, First Department, February 27, 2014No-show voids coverage; insurer need not show a timely denial (also decides)Held that after the assignor's IME nonappearance the insurer could deny all claims retroactively to the date of loss regardless of whether its denials were timely issued.
MDJ Med., P.C. v New York Cent. Mut. Ins. Co. (2013 NY Slip Op 51797(U)) Appellate Term, First Department, October 28, 2013No-show voids coverage; insurer need not show a timely denial (also decides)Added that once the assignor failed to appear for the IMEs, the insurer could deny all claims retroactively to the date of loss regardless of whether the denials were timely issued.

Appellate Term, Second Department (404 decisions)

One RX Chemist, Inc. v Nationwide Mut. Ins. Co. (2026 NY Slip Op 51309(U)) Appellate Term, Second Department, June 17, 2026Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established, undisputed, that it timely denied the claim on the no-show ground after the provider missed the last scheduled EUO.
Bridgeview Supply Corp. v Nationwide Mut. Ins. Co. (2026 NY Slip Op 50190(U)) Appellate Term, Second Department, January 16, 2026Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show a timely denial after the last scheduled EUO and held its affidavits proved the denial was timely mailed.
Harvey Family Chiropractic, Physical Therapy & Acupuncture, PLLC v MVAIC (2025 NY Slip Op 51971(U)) Appellate Term, Second Department, December 5, 2025No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld MVAIC not entitled to summary judgment on the EUO no-show defense because it failed to establish it was not precluded, the 30-day period having run from receipt of the claims regardless of covered-person status.
John A. Nasrinpay 2 v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 51833(U)) Appellate Term, Second Department, November 7, 2025Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge and held the insurer's affidavits raised a presumption that its no-show denial forms were timely mailed, supporting dismissal.
NY Wellness Med., P.C. v MVAIC (2025 NY Slip Op 51165(U)) Appellate Term, Second Department, July 11, 2025No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it was not precluded from its EUO no-show defense because its proof did not establish timely, proper denials issued within 30 days of the last scheduled EUO.
MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50830(U)) Appellate Term, Second Department, May 16, 2025Timely denial required as part of the no-show defense, and the insurer showed itHeld the pre-claim initial EUO letter and timely follow-ups tolled the time to pay or deny, and the denials issued after the last scheduled EUO were timely and proper.
MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50831(U)) Appellate Term, Second Department, May 16, 2025Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely and proper denials issued after the provider's failure to appear at the last scheduled EUO, as an element of its defense.
Northern Med. Care, P.C. v Nationwide Affinity Ins. Co. of Am. (2024 NY Slip Op 51822(U)) Appellate Term, Second Department, December 19, 2024Timely denial required as part of the no-show defense, and the insurer showed itHeld a denial issued six days after the last of several timely scheduled EUOs was timely, rejecting the provider's argument that the insurer could not schedule more than two EUOs before denying.

Show all 404 decisions

LPM Pharm., Inc. v Nationwide Prop. & Cas. Ins. Co. (2024 NY Slip Op 51191(U)) Appellate Term, Second Department, August 13, 2024Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, among the elements of its EUO no-show defense, it was undisputed that the claim was timely denied within 30 days of the second missed EUO.
Bronx Chiropractic Rehabilitation, P.C. v MVAIC (2024 NY Slip Op 50799(U)) Appellate Term, Second Department, June 7, 2024No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld MVAIC failed to show it was not precluded from its EUO no-show defense because its papers did not establish timely and proper denials within 30 days of the last scheduled EUO, the 30 days running from receipt regardless of covered-person status.
GPLW Acupuncture, P.C. v Nationwide Mut. Ins. Co. (2024 NY Slip Op 50395(U)) Appellate Term, Second Department, March 14, 2024Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established, as part of its EUO no-show defense, that it issued timely and proper denials following the provider's failure to appear at the last scheduled EUO.
GPLW Acupuncture, P.C. v Nationwide Mut. Ins. Co. (2024 NY Slip Op 50397(U)) Appellate Term, Second Department, March 14, 2024Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denials on the EUO no-show ground were timely mailed, as part of its prima facie no-show defense.
Horizon P.T. Care, P.C. v State Farm Mut. Auto. Ins. Co. (2023 NY Slip Op 50442(U)) Appellate Term, Second Department, April 14, 2023Timely denial required as part of the no-show defense, and the insurer showed it (also decides)For the claims not covered by the declaratory judgment, held the insurer's affidavits raised a presumption that the denial forms were timely mailed, sustaining the EUO no-show dismissal.
Allstate Chiropractic, P.C. v Nationwide Affinity Ins. Co. of Am. (2023 NY Slip Op 50299(U)) Appellate Term, Second Department, March 24, 2023No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not shown it was not precluded from its EUO no-show defense because its denials issued more than 30 days after the second nonappearance, and accommodating a later EUO did not extend the time.
MUA Chiropractic Healthcare, PLLC v Nationwide Mut. Ins. Co. (2022 NY Slip Op 51384(U)) Appellate Term, Second Department, December 29, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show it issued timely denials as part of its EUO no-show defense and found that element established, as the lower court had found in effect under CPLR 3212 (g).
MSB Physical Therapy v Nationwide Ins. (2022 NY Slip Op 51381(U)) Appellate Term, Second Department, December 23, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to establish it timely denied the claims after the second EUO nonappearance, so it did not show it was not precluded from raising the no-show defense and its motion should have been denied.
MSB Physical Therapy, P.C. v Nationwide Ins. (2022 NY Slip Op 51378(U)) Appellate Term, Second Department, December 23, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer did not show it was not precluded from its EUO no-show defense because it failed to establish that it timely denied the claims after the provider's second nonappearance.
FJL Med. Servs., P.C. v Nationwide Ins. (2022 NY Slip Op 51213(U)) Appellate Term, Second Department, December 9, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the denial untimely because it issued well over 30 days after the second EUO nonappearance; scheduling further EUOs could not extend the toll, so the insurer did not show it was not precluded from the no-show defense.
Ezra Supply, Inc. v Nationwide Affinity Ins. Co. of Am. (2022 NY Slip Op 22383) Appellate Term, Second Department, December 9, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not shown it was not precluded from its EUO no-show defense because the toll ended at the second nonappearance, later EUO letters did not extend it, and the denial issued after the 30-day deadline.
NGM Acupuncture, P.C. v Nationwide Ins. Co. (2022 NY Slip Op 51271(U)) Appellate Term, Second Department, December 2, 2022Timely denial required as part of the no-show defense, and the insurer showed itHeld the EUO no-show denials timely: two claims were denied within 30 days of receipt, and the third, received after an initial EUO was scheduled, stayed tolled through a timely follow-up and was denied within 30 days of the second nonappearance.
Spring Rehab PT P.C. v Nationwide Affinity Ins. Co. (2022 NY Slip Op 51268(U)) Appellate Term, Second Department, December 2, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denials on the EUO no-show ground were timely mailed, as part of its prima facie entitlement to dismissal.
Heal-Rite, P.T., P.C. v State Farm Mut. Auto. Ins. Co. (2022 NY Slip Op 51246(U)) Appellate Term, Second Department, December 2, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denials on the EUO no-show ground were timely mailed, as part of its prima facie entitlement to dismissal.
Wellness Plaza Acupuncture, P.C. v Nationwide Ins. (2022 NY Slip Op 50934(U)) Appellate Term, Second Department, September 23, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof raised a presumption that its no-show denials were timely mailed, and the provider raised no triable issue on their timeliness.
Columbus Imaging Ctr., LLC v Erie Ins. Co. of N.Y. (2022 NY Slip Op 50929(U)) Appellate Term, Second Department, September 23, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer demonstrated it timely denied the claim on the ground of the assignor's IME nonappearance, completing its defense.
Nassau Chiropractic Servs., P.C. v Travelers Indem. Co. (2022 NY Slip Op 50933(U)) Appellate Term, Second Department, September 23, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial form was timely mailed, completing its prima facie EUO no-show defense.
Hands On Physical Therapy Care v Nationwide Ins. (2022 NY Slip Op 50797(U)) Appellate Term, Second Department, August 12, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer not entitled to dismissal of three claims because it failed to show it denied them within 30 days of the second EUO nonappearance, while a fourth claim's denial was timely given the tolling scheduling letters.
Chi P&L Acupuncture, P.C. v GEICO Gen. Ins. Co. (2022 NY Slip Op 50768(U)) Appellate Term, Second Department, July 15, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it timely denied the claims after the second EUO nonappearance, so it did not demonstrate it was not precluded from raising the no-show defense.
Warton Supplies, Inc. v GEICO Indem. Co. (2022 NY Slip Op 50770(U)) Appellate Term, Second Department, July 15, 2022Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's contention and held the insurer's proof raised a presumption that its denial forms were timely mailed, sustaining the EUO no-show dismissal.
Clear Water Psychological Servs., P.C. v Mid-Century Ins. Co. (2022 NY Slip Op 50621(U)) Appellate Term, Second Department, July 1, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld a triable issue whether the denials were timely, since they issued more than 30 days after the second scheduled EUO and the insurer did not prove the first was mutually rescheduled, so preclusion was unresolved.
Citycare Chiropractic, P.C. v Repwest Ins. Co. (2022 NY Slip Op 50619(U)) Appellate Term, Second Department, July 1, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer demonstrated that it timely denied the claims on the IME no-show ground, completing its prima facie defense.
Ezra Supply, Inc. v State Farm Mut. Auto Ins. Co. (2022 NY Slip Op 50613(U)) Appellate Term, Second Department, June 17, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established prima facie that the claims were timely denied on the EUO no-show ground.
New York Wellness PT, P.C. v State Farm Mut. Auto. Ins. Co. (2022 NY Slip Op 50608(U)) Appellate Term, Second Department, June 17, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer failed to establish as a matter of law that it timely denied the claim after the two EUO nonappearances, one of two reasons its no-show defense failed on summary judgment.
Hand By Hand PT, P.C. v Nationwide Prop. & Cas. Ins. Co. (2022 NY Slip Op 50607(U)) Appellate Term, Second Department, June 17, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer demonstrated that the claims were timely denied on the EUO no-show ground, as part of its prima facie showing.
Metropolitan Surgical Servs., P.C. v 21st Century Ins. Co. (2022 NY Slip Op 50606(U)) Appellate Term, Second Department, June 17, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer demonstrated that it timely denied the claim on the IME no-show ground, completing its prima facie entitlement to summary judgment.
Prestige Med., P.C. v Metropolitan Prop. & Cas. Ins. Co. (2022 NY Slip Op 50591(U)) Appellate Term, Second Department, June 10, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely mailed denial forms denying the claims on the EUO no-show ground.
Dr. Orenbakh Psychologist, P.C. v Nationwide Affinity Ins. Co. of Am. (2022 NY Slip Op 50566(U)) Appellate Term, Second Department, June 10, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer not shown free of preclusion on one claim because its first EUO letter went out over 30 days after receipt, a nullity; other claims were timely denied on the no-show ground.
SVP Med Supply, Inc. (B) v GEICO (2022 NY Slip Op 50585(U)) Appellate Term, Second Department, June 10, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial forms were timely mailed, completing the prima facie EUO no-show defense under the timely-denial element.
Pavlova v Nationwide Ins. (2022 NY Slip Op 50559(U)) Appellate Term, Second Department, June 3, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show two demanded EUOs, two nonappearances and a timely denial, and found the insurer's prima facie showing complete once mailing of the scheduling letters was established.
EA Chiropractic Diagnostics, P.C. v GEICO Ins. (2022 NY Slip Op 50557(U)) Appellate Term, Second Department, June 3, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it timely denied the claims after the provider missed both the initial and follow-up EUOs, so it did not show it was not precluded from the no-show defense.
Warton Supplies, Inc. v GEICO Gen. Ins. Co. (2022 NY Slip Op 50554(U)) Appellate Term, Second Department, June 3, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of the denial of claim forms as part of its EUO no-show prima facie case under the element list requiring a timely denial.
Parisien v Travelers Ins. Co. (2022 NY Slip Op 50553(U)) Appellate Term, Second Department, June 3, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims were timely denied on the EUO no-show ground, together with mailing and nonappearance, entitling it to summary judgment.
Psychology After Acc., P.C. v Nationwide Ins. Co. of N.Y. (2022 NY Slip Op 50366(U)) Appellate Term, Second Department, May 6, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to establish it timely denied the claims after the provider's second EUO nonappearance, so it did not show it was not precluded from the no-show defense.
Pavlova v 21st Century Ins. Co. (2022 NY Slip Op 50363(U)) Appellate Term, Second Department, April 29, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show a timely denial after the assignor's alleged nonappearance at both the initial and follow-up EUOs, so it did not show it was not precluded and summary judgment should have been denied.
NY Wellness Med., P.C. v Nationwide Mut. Ins. Co. (2022 NY Slip Op 50359(U)) Appellate Term, Second Department, April 28, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that a timely denial is an element of the insurer's EUO no-show defense and relied on the finding that the denial was timely and properly mailed in granting summary judgment.
AB Quality Health Supply Corp. v Nationwide Ins. (2022 NY Slip Op 50299(U)) Appellate Term, Second Department, April 1, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims were timely denied on the EUO no-show ground as part of its prima facie showing.
Arcadia Acupuncture, P.C. v Nationwide Ins. Co. (2021 NY Slip Op 51258(U)) Appellate Term, Second Department, December 22, 2021No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to timely deny the claims received in March and April 2018 after the EUO no-shows, so it could not defeat liability on them, while claims received later were timely denied.
Warton Supplies, Inc. v GEICO (Gov Empls.) (2021 NY Slip Op 51253(U)) Appellate Term, Second Department, December 22, 2021Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge and held the insurer's proof raised a presumption that its denial forms were timely mailed, supporting the EUO no-show dismissal.
Island Life Chiropractic Pain Care, PLLC v 21st Century Ins. Co. (2021 NY Slip Op 21340) Appellate Term, Second Department, December 10, 2021No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO toll ended at the second nonappearance, so the insurer did not show it was not precluded on the claim denied more than 30 days later, but later-received claims were properly denied within 30 days of receipt.
Essential Health Chiropractic, P.C. v National Liab. & Fire Ins. Co. (2021 NY Slip Op 50881(U)) Appellate Term, Second Department, September 9, 2021No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the provider's owner raised a triable issue whether the denials on the no-show ground were mailed, so the insurer did not establish its defense as a matter of law.
Allay Med. Servs., P.C. v Nationwide Ins. (2021 NY Slip Op 50764(U)) Appellate Term, Second Department, July 30, 2021No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to establish that it timely denied the claim after the second EUO nonappearance, so it did not show it was not precluded from raising the no-show defense.
Englinton Med., P.C. v Ameriprise Ins. Co. (2021 NY Slip Op 50715(U)) Appellate Term, Second Department, July 22, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that bills 1 to 13 were timely denied on the EUO no-show ground, along with mailing and nonappearance.
Hand By Hand PT, P.C. v Titan Indem. Co. (2021 NY Slip Op 50644(U)) Appellate Term, Second Department, July 2, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims were timely denied on the EUO no-show ground, as part of its prima facie defense.
Ditmas Primary Med. Care, P.C. v Republic W. Ins. Co. (2021 NY Slip Op 50438(U)) Appellate Term, Second Department, May 14, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavit established timely mailing of the denials as part of its EUO no-show prima facie case.
BNE Clinton Med., P.C. v Republic W. Ins. Co. (2021 NY Slip Op 50433(U)) Appellate Term, Second Department, May 14, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of the denials of the six claims denied on the EUO no-show ground as part of its prima facie case.
City Anesthesia Healthcare, P.C. v Erie Ins. Co. of N.Y. (2021 NY Slip Op 50135(U)) Appellate Term, Second Department, February 19, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer demonstrated that it timely denied the claim based on the assignor's failure to appear for the IMEs.
A.C. Med., P.C. v Ameriprise Ins. Co. (2020 NY Slip Op 51378(U)) Appellate Term, Second Department, November 13, 2020No-show defense is subject to preclusion and fails for want of a timely, proper denialGranted dismissal of one provider's claims as timely denied after two EUO nonappearances, but held the insurer failed to establish it timely denied the other provider's claims after the initial and follow-up EUO nonappearances.
21st Century Pharm., Inc. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 51377(U)) Appellate Term, Second Department, November 13, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer also established that it timely denied the claims on the IME no-show ground, entitling it to dismissal.
A.C. Med., P.C. v Ameriprise Ins. Co. (2020 NY Slip Op 51376(U)) Appellate Term, Second Department, November 13, 2020No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to establish as a matter of law that it timely denied the claims after the provider failed to appear at both the initial and follow-up EUOs, so summary judgment was denied.
Avalon Radiology, P.C. v Global Liberty Ins. (2020 NY Slip Op 51374(U)) Appellate Term, Second Department, November 13, 2020Timely denial required as part of the no-show defense, and the insurer showed itReversed a directed verdict that the IME no-show denials were untimely, holding the time to deny did not run while a timely requested EUO was pending, so the insurer was not precluded and a new trial was required.
Island Life Chiropractic Pain Care, PLLC v Ameriprise Ins. (2020 NY Slip Op 51369(U)) Appellate Term, Second Department, November 13, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims were timely denied on the EUO no-show ground as part of its entitlement to dismissal.
NL Quality Med., P.C. v GEICO Ins. Co. (2020 NY Slip Op 51367(U)) Appellate Term, Second Department, November 13, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Upheld the implicit finding that the denial of claim forms on the EUO no-show ground were timely mailed, so the defense was established.
21st Century Pharm., Inc. v Integon Natl. Ins. Co. (2020 NY Slip Op 51364(U)) Appellate Term, Second Department, November 13, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that a timely denial is an element of the insurer's EUO no-show defense and relied on the finding that the denial was timely and properly mailed in granting summary judgment.
NL Quality Med., P.C. v GEICO Ins. Co. (2020 NY Slip Op 51340(U)) Appellate Term, Second Department, November 6, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof established timely mailing of its denials along with the EUO letters and nonappearance, supporting the no-show defense on three causes of action.
Alpine Chiropractic, P.C. v Integon Natl. Ins. Co. (2020 NY Slip Op 51332(U)) Appellate Term, Second Department, November 6, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims were timely denied on the IME no-show ground as part of its entitlement to dismissal.
EA Chiropractic Diagnostics, P.C. v GEICO Ins. (2020 NY Slip Op 51331(U)) Appellate Term, Second Department, November 6, 2020No-show defense is subject to preclusion and fails for want of a timely, proper denialGranted dismissal of one claim timely denied after the IME no-show, but held the insurer did not show it timely denied the remaining claims after the EUO nonappearances, so it did not show it was not precluded.
Lacina v Hereford Ins. Co. (2020 NY Slip Op 51329(U)) Appellate Term, Second Department, November 6, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the claims examiner's affidavit showed the denial based on the IME nonappearance was timely mailed, supporting dismissal.
ESA Med. Supply, Inc. v Nationwide Affinity Ins. Co. of Am. (2020 NY Slip Op 51324(U)) Appellate Term, Second Department, November 6, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Rejected the challenge to the affidavit proving timely mailing of the denials, leaving the timely denial on the EUO no-show ground established.
Charles Deng Acupuncture, P.C. v Travelers Ins. Co. (2020 NY Slip Op 51320(U)) Appellate Term, Second Department, November 6, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims were timely denied on the EUO no-show ground as part of its entitlement to dismissal.
Quality Health Supply Corp. v Nationwide Ins. (2020 NY Slip Op 51226(U)) Appellate Term, Second Department, October 16, 2020No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not shown it was not precluded from its EUO no-show defense because the 30 days ran from the second nonappearance and its denial came more than 30 days later.
Longevity Med. Supply, Inc. v Nationwide Ins. (2020 NY Slip Op 51133(U)) Appellate Term, Second Department, October 2, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims were timely denied on the EUO no-show ground as part of its entitlement to dismissal.
Focus Chiropractic, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 51006(U)) Appellate Term, Second Department, August 28, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Required the insurer to show that the claim, received after the IME no-shows, was timely denied on that ground, and found that showing made.
S.O.V. Acupuncture, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 51004(U)) Appellate Term, Second Department, August 28, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the IME no-show defense established for one claim because, besides mailing and nonappearance, the insurer showed it timely denied that claim on the no-show ground.
Quest Supply, Inc. v NY Cent. Mut. Fire Ins. Co. (2020 NY Slip Op 51003(U)) Appellate Term, Second Department, August 28, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Required proof that the denial based on the IME nonappearance was timely mailed and found the claim representative's affidavit established it.
NL Quality Med., P.C. v GEICO Ins. Co. (2020 NY Slip Op 50997(U)) Appellate Term, Second Department, August 28, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer established timely mailing of its denials as part of its prima facie EUO no-show defense under the two-demands, two-nonappearances, timely-denial formula.
Psychology YME, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 50992(U)) Appellate Term, Second Department, August 28, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established, among the elements of its EUO no-show defense, that it issued a timely denial of the claim after the assignor twice failed to appear.
Parisien v Ameriprise Ins. (2020 NY Slip Op 50990(U)) Appellate Term, Second Department, August 28, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Listed timely denial of the claim on the EUO no-show ground among the elements the insurer established, and found it shown.
Excel Surgery Ctr., LLC v MVAIC (2020 NY Slip Op 51016(U)) Appellate Term, Second Department, August 27, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed it timely mailed a denial on the IME no-show ground upon receipt of the claim, as part of its prima facie defense.
Accelerated Med. Supply, Inc. v Ameriprise Ins. Co. (2020 NY Slip Op 50741(U)) Appellate Term, Second Department, June 18, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Explained that the initial EUO request tolled the time to deny pending and later claims until the second nonappearance, and found the denials on that ground timely mailed.
Medcare Supply, Inc. v Global Liberty Ins. (2020 NY Slip Op 50231(U)) Appellate Term, Second Department, February 14, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer demonstrated prima facie timely mailing of the denial of claim form as part of its IME no-show defense.
Omphil Care, Inc. v GEICO Ins. Co. (2019 NY Slip Op 52065(U)) Appellate Term, Second Department, December 13, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof sufficient to raise a presumption that the denial of claim form was timely mailed, as part of its EUO no-show defense.
Aries Chiropractic, P.C. v Ameriprise Ins. Co. (2019 NY Slip Op 52064(U)) Appellate Term, Second Department, December 13, 2019Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge to the EUO no-show denial, holding the denial of claim form did not need to state the dates of the EUOs the provider failed to attend.
Crystal Acupuncture, P.C. v Travelers Ins. (2019 NY Slip Op 52055(U)) Appellate Term, Second Department, December 13, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof raised a presumption that its denials of the EUO no-show claims were timely mailed, supporting dismissal of those claims.
Margulis v Travelers Ins. (2019 NY Slip Op 52051(U)) Appellate Term, Second Department, December 13, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Listed timely denial of the claims on the EUO no-show ground among the elements the insurer established, and found it shown.
Active Care Med. Supply Corp. v MVAIC (2019 NY Slip Op 52045(U)) Appellate Term, Second Department, December 13, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld MVAIC's IME no-show defense precluded because it neither denied the claims within 30 days nor timely requested verification, the 30-day rule applying to MVAIC as to any insurer.
Beacon Acupuncture, P.C. v Hertz Claim Mgt. (2019 NY Slip Op 52059(U)) Appellate Term, Second Department, December 13, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)For the earlier claims, held the insurer established that they were timely denied on the EUO no-show ground, as an element of its defense.
Big Apple Med. Supply, Inc. v Titan & Nationwide (2019 NY Slip Op 52067(U)) Appellate Term, Second Department, December 13, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show two duly demanded EUOs, two nonappearances and a timely denial, and held the insurer established its entitlement to summary judgment.
Omphil Care, Inc. v GEICO Ins. Co. (2019 NY Slip Op 51979(U)) Appellate Term, Second Department, December 6, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Agreed with the lower court that the insurer established timely and proper mailing of its denials as part of the EUO no-show defense.
Pro-Align Chiropractic, P.C. v Integon Natl. Ins. Co. (2019 NY Slip Op 51967(U)) Appellate Term, Second Department, December 6, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer established timely mailing of its denial forms as part of its IME no-show defense.
Longevity Med. Supply, Inc. v Travelers Prop. & Cas. Ins. Co. (2019 NY Slip Op 51956(U)) Appellate Term, Second Department, November 29, 2019Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer established its EUO no-show defense, including that its denials based on the assignor's two nonappearances were properly and timely mailed, rejecting the provider's challenge to the denial mailing proof.
Parisien v Nationwide Ins. (2019 NY Slip Op 51949(U)) Appellate Term, Second Department, November 29, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer, having failed to establish that its denial was timely mailed, did not show it was not precluded from asserting its EUO no-show defense, so summary judgment was denied.
Ultra Ortho Prods., Inc. v GEICO Ins. Co. (2019 NY Slip Op 51844(U)) Appellate Term, Second Department, November 15, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Upheld the lower court's implicit finding that the denial of claim forms were timely mailed, as part of the EUO no-show defense.
Allay Med. Servs., P.C. v Travelers Ins. Co. (2019 NY Slip Op 51806(U)) Appellate Term, Second Department, November 8, 2019Timely denial required as part of the no-show defense, and the insurer showed itFound the insurer established timely mailing of the denial of claim form as part of its EUO no-show defense.
Valdan Acupuncture, P.C. v Global Liberty Ins. Co. of NY (2019 NY Slip Op 51705(U)) Appellate Term, Second Department, October 18, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established, as part of its IME no-show defense, that the claim had been timely denied on the ground of the assignor's nonappearance.
Body Acupuncture Care, P.C. v Erie Ins. Co. of N.Y. (2019 NY Slip Op 51695(U)) Appellate Term, Second Department, October 18, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims had been timely denied on the ground of the assignor's failure to appear for IMEs, as part of its no-show defense.
Tyorkin v Global Liberty Ins. (2019 NY Slip Op 51689(U)) Appellate Term, Second Department, October 18, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it had timely denied the claims on the IME no-show ground, completing its defense.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2019 NY Slip Op 51684(U)) Appellate Term, Second Department, October 18, 2019Timely denial required as part of the no-show defense, and the insurer showed itApplied the rule that the insurer must show a timely denial as an element of its EUO no-show defense and found the denial presumptively timely mailed.
Allay Med. Servs., P.C. v Metropolitan Gen. Ins. Co. (2019 NY Slip Op 51617(U)) Appellate Term, Second Department, October 11, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the claims had been timely denied on the ground of the assignor's EUO nonappearance, as part of its defense.
Ocean One Physical Therapy, P.C. v 21st Century Centennial Ins. Co. (2019 NY Slip Op 51272(U)) Appellate Term, Second Department, August 2, 2019Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the time to deny was not tolled, holding that although the delay letters did not toll it, the EUO scheduling letters did.
Acupuncture Now, P.C. v Travelers Ins. Co. (2019 NY Slip Op 51255(U)) Appellate Term, Second Department, August 2, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held that, for one claim, the insurer established its EUO no-show defense including that its time was tolled and the claim was timely denied on that ground.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2019 NY Slip Op 51161(U)) Appellate Term, Second Department, July 12, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that a timely denial is an element of the EUO no-show defense and found the denial presumptively timely mailed.
Central Park Physical Medicine & Rehab., P.C. v IDS Prop. & Cas. Ins. Co. (2019 NY Slip Op 51148(U)) Appellate Term, Second Department, July 11, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of denial forms based on the EUO nonappearance, as part of its defense.
Valdan Acupuncture, P.C. v 21st Century Advantage Ins. Co. (2019 NY Slip Op 50822(U)) Appellate Term, Second Department, May 24, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed timely mailing of the denials based on the IME nonappearance, and granted it summary judgment on that ground.
Oleg's Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2019 NY Slip Op 50760(U)) Appellate Term, Second Department, May 10, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show it timely denied the claims and agreed the record established timely and proper mailing of the denial of claim forms, so the EUO no-show defense warranted summary judgment.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2019 NY Slip Op 50759(U)) Appellate Term, Second Department, May 10, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that a timely denial is an element of the EUO no-show defense and found the denial presumptively timely mailed.
Pavlova v Hartford Ins. Co. (2019 NY Slip Op 50693(U)) Appellate Term, Second Department, May 3, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)In upholding the EUO no-show dismissal, held the insurer's proof sufficient to raise a presumption that its denial of claim form was properly mailed, treating proof of the denial as part of the defense.
K.O. Med., P.C. v IDS Prop. Cas. Ins. Co. (2019 NY Slip Op 50687(U)) Appellate Term, Second Department, May 3, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held that, for the remaining claims, the insurer established timely mailing of its denial of claim forms along with the EUO letters and nonappearances, so dismissal of those claims was proper.
BCc Chiropractic, P.C. v Farmers New Century Ins. Co. (2019 NY Slip Op 50680(U)) Appellate Term, Second Department, May 3, 2019Timely denial required as part of the no-show defense, and the insurer showed itHeld the EUO no-show claim timely denied, although the insurer's delay letter did not toll its time, because the EUO scheduling letters were timely mailed and the denial on that ground timely followed.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2019 NY Slip Op 50678(U)) Appellate Term, Second Department, May 3, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held that, because the follow-up EUO letter for the first cause of action was not shown timely sent, the insurer did not demonstrate it was not precluded from its no-show defense on that claim, while it established the elements including timely denial on the second.
First Class Med., P.C. v Ameriprise Ins. Co. (2019 NY Slip Op 50477(U)) Appellate Term, Second Department, March 28, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held that a timely initial EUO request tolled the time to deny prior and later claims until the second nonappearance, and that the insurer timely mailed denials on the no-show ground for 17 claims.
Vital Chiropractic, P.C. v Nationwide Ins. Co. (2019 NY Slip Op 50425(U)) Appellate Term, Second Department, March 22, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer showed timely mailed denials on the IME no-show ground for all claims but one, for which a fact issue as to whether the claim was ever received left the insurer without summary judgment.
Actual Chiropractic, P.C. v State Farm Ins. (2019 NY Slip Op 50421(U)) Appellate Term, Second Department, March 22, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show two duly demanded EUOs, two nonappearances and a timely denial, and found the claims timely denied on the no-show ground.
Oleg's Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2019 NY Slip Op 51045(U)) Appellate Term, Second Department, March 1, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that a timely denial is an element of the EUO no-show defense and upheld the finding that the denials were timely and properly mailed.
Bronx Chiropractic Care, P.C. v State Farm Ins. (2019 NY Slip Op 51041(U)) Appellate Term, Second Department, March 1, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that a timely denial is an element of the EUO no-show defense and upheld the finding that the denials were timely and properly mailed.
Island Life Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2019 NY Slip Op 51038(U)) Appellate Term, Second Department, March 1, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the timely-denial element and found the insurer's affidavits established that the denial form had been timely mailed under its standard office practices.
Dynamic Balance Acupuncture, P.C. v State Farm Ins. (2019 NY Slip Op 50171(U)) Appellate Term, Second Department, February 8, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show a timely denial as part of its EUO no-show defense and granted judgment because that element, found under CPLR 3212 (g), was not disputed.
Healthy Way Acupuncture, P.C. v Country-Wide Ins. Co. (2019 NY Slip Op 50094(U)) Appellate Term, Second Department, January 18, 2019Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held after trial that the insurer properly and timely denied three claims on the ground of the assignor's IME no-show, having proved timely mailing of the scheduling letters and denials.
A & F Med., P.C. v Global Liberty Ins. Co. of N.Y. (2018 NY Slip Op 51812(U)) Appellate Term, Second Department, December 7, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its EUO no-show defense because it sent the provider no delay letter with the second EUO letter, so it did not show the time to pay or deny was tolled.
Gentlecare Ambulatory Anesthesia Servs.; Lyonel F. Paul, M.D. v GEICO Ins. Co. (2018 NY Slip Op 51773(U)) Appellate Term, Second Department, November 30, 2018Timely denial required as part of the no-show defense, and the insurer showed itApplied the rule that the insurer must show a timely denial and held, over the provider's challenge, that its proof raised a presumption the denial of claim form was timely mailed.
Metro Psychological Servs., P.C. v ELRAC, Inc. (2018 NY Slip Op 51760(U)) Appellate Term, Second Department, November 30, 2018Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer's proof sufficient to show proper mailing of the denial of claim form, as part of the IME no-show defense on which it obtained dismissal.
Veraso Med. Supply Corp. v 21st Century Ins. Co. (2018 NY Slip Op 51696(U)) Appellate Term, Second Department, November 23, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer's EUO no-show cross motion should have been denied because it failed to establish that it timely denied the claim after the assignor's nonappearances, so it did not show it was not precluded.
Gentlecare Ambulatory Anesthesia Services; Lyonel F. Paul, M.D. v GEICO Ins. Co. (2018 NY Slip Op 51653(U)) Appellate Term, Second Department, November 16, 2018Timely denial required as part of the no-show defense, and the insurer showed itHeld, over the provider's challenge, that the insurer's proof gave rise to a presumption that the denial of claim form on the EUO no-show ground was timely mailed.
PR Med., P.C. v Travelers Home & Mar. Ins. Co. (2018 NY Slip Op 51649(U)) Appellate Term, Second Department, November 16, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Listed among the elements the insurer established that the claims had been timely denied on the EUO no-show ground.
Maiga Prods. Corp. v State Farm Mut. Auto. Ins. Co. (2018 NY Slip Op 51646(U)) Appellate Term, Second Department, November 16, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Listed among the elements the insurer established that the claims had been timely denied on the EUO no-show ground.
Jamaica Wellness Med., P.C. v ELRAC, Inc. (2018 NY Slip Op 51637(U)) Appellate Term, Second Department, November 16, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial of claim forms were timely mailed, treating a timely denial as part of the EUO no-show defense it established.
Gentlecare Ambulatory Anesthesia Servs. v Allstate Ins. Co. (2018 NY Slip Op 51607(U)) Appellate Term, Second Department, November 9, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialDenied the insurer summary judgment on its EUO no-show defense because it failed to prove timely mailing of the denial and so did not show it was not precluded from asserting the defense.
Barshay v 21st Century Centennial Ins. Co. (2018 NY Slip Op 51605(U)) Appellate Term, Second Department, November 9, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it timely denied the claims on the EUO no-show ground because its claim representative's affidavit was unsworn and could not establish the denials' timeliness.
Island Life Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2018 NY Slip Op 51552(U)) Appellate Term, Second Department, November 2, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show a timely denial as part of its EUO no-show defense and granted judgment because that element, found under CPLR 3212 (g), was unchallenged.
Island Life Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2018 NY Slip Op 51551(U)) Appellate Term, Second Department, November 2, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Listed among the elements the insurer established that the claims had been timely denied on the EUO no-show ground.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2018 NY Slip Op 50864(U)) Appellate Term, Second Department, June 8, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show a timely denial as an element of its EUO no-show defense and found the denial of claim form timely mailed.
Comprehensive Care Physical Therapy, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50848(U)) Appellate Term, Second Department, June 1, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialDenied the insurer summary judgment on its IME no-show defense because it did not prove timely mailing of the denials and thus did not show it was not precluded from asserting the defense.
Maiga Prods. Corp. v 21st Century Ins. Co. (2018 NY Slip Op 50845(U)) Appellate Term, Second Department, June 1, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Treated proof that the denial of claim forms were properly mailed as part of the insurer's EUO no-show defense and found that proof sufficient.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2018 NY Slip Op 50837(U)) Appellate Term, Second Department, June 1, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof raised a presumption that its denial of claim form was properly mailed and, citing the Clennon elements including a timely denial, rejected the provider's remaining contentions against the EUO no-show defense.
Acupuncture Healthcare Plaza I, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50835(U)) Appellate Term, Second Department, June 1, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer, lacking proof that its denials were timely mailed, failed to show it was not precluded from asserting its IME no-show defense, so it was denied summary judgment.
Compas v Travelers Ins. Co. (2018 NY Slip Op 50821(U)) Appellate Term, Second Department, June 1, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Required and found proof that the denial of claim forms on the EUO no-show ground were timely mailed, while the dispute centered on nonappearance.
Valdan Acupuncture, P.C. v NY Cent. Mut. Fire Ins. Co. (2018 NY Slip Op 50739(U)) Appellate Term, Second Department, May 18, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not preserved its IME no-show defense for three claims because it had denied them on other grounds, so it could not obtain summary judgment on those claims on that ground.
Maiga Prods. Corp. v State Farm Mut. Auto. Ins. Co. (2018 NY Slip Op 50736(U)) Appellate Term, Second Department, May 18, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show two EUO demands, two nonappearances and a timely denial, and upheld the finding that the denial forms were timely and properly mailed.
Goldstar Equip., Inc. v Mercury Cas. Co. (2018 NY Slip Op 50576(U)) Appellate Term, Second Department, April 13, 2018Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's assertion and held the insurer established that its denials on the EUO no-show ground were timely mailed.
Motionpro Physical Therapy v Hereford Ins. Co. (2018 NY Slip Op 50251(U)) Appellate Term, Second Department, February 16, 2018Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held that, for the second claim, the insurer established mailing of IME letters, the assignor's nonappearance and a timely denial on that ground, entitling it to dismissal.
Choice Health Chiropractic, P.C. v American Tr. Ins. Co. (2018 NY Slip Op 50185(U)) Appellate Term, Second Department, February 8, 2018No-show defense is subject to preclusion and fails for want of a timely, proper denialUpheld dismissal of one claim timely denied on the IME no-show ground, but denied summary judgment on another because an issue of fact on verification tolling left the denial's timeliness unestablished.
Moon Rehab, P.T., P.C. v Ameriprise Ins. Co. (2017 NY Slip Op 51877(U)) Appellate Term, Second Department, December 22, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer's proof raised a presumption that the denial of claims form on the EUO no-show ground was timely mailed, supporting dismissal.
Bronx Acupuncture Therapy, P.C. v A. Cent. Ins. Co. (2017 NY Slip Op 51870(U)) Appellate Term, Second Department, December 22, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted summary judgment because, besides proving the IME no-show, the insurer's papers established it timely denied the claims on that ground.
Village Med. Supply, Inc. v Citiwide Auto Leasing Ins. Co. (2017 NY Slip Op 51869(U)) Appellate Term, Second Department, December 22, 2017Timely denial required as part of the no-show defense, and the insurer showed itFound the denial forms on the IME no-show ground timely mailed and rejected the provider's argument about tolling of the insurer's time to pay or deny.
Careful Complete Med., P.C. v Hartford Ins. Co. (2017 NY Slip Op 51858(U)) Appellate Term, Second Department, December 22, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer's proof raised a presumption that the denial of claim forms on the EUO no-show ground were properly mailed, supporting dismissal.
Silver Acupuncture, P.C. v GEICO (Gov Employees) (2017 NY Slip Op 51876(U)) Appellate Term, Second Department, December 22, 2017No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer did not show it timely denied the claims after the provider missed both the initial and follow-up EUOs, so it failed to demonstrate it was not precluded from raising the defense.
Lynbrook PT & OT, PLLC v Ameriprise Ins. Co. (2017 NY Slip Op 51801(U)) Appellate Term, Second Department, December 19, 2017No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to establish its EUO no-show defense for four claims because, besides the untimely initial request, its papers did not demonstrate that those claims had been timely denied.
JYW Med., P.C. v IDS Prop. Ins. Co. (2017 NY Slip Op 51800(U)) Appellate Term, Second Department, December 19, 2017Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer timely denied one provider's claims on the EUO no-show ground and, reversing the lower court, that the denial forms were not defective for omitting the EUO dates.
Masigla v Travelers Ins. Co. (2017 NY Slip Op 51794(U)) Appellate Term, Second Department, December 19, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Sustained the EUO no-show dismissal after finding the insurer's proof sufficient to presume its denial of claim forms were properly mailed, treating a proper denial as part of the defense.
Daily Med. Equip. Distrib. Ctr., Inc. v ELRAC, Inc. (2017 NY Slip Op 51805(U)) Appellate Term, Second Department, December 19, 2017Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument and held the insurer's affidavit sufficient to show that the denial based on the IME no-show was timely mailed.
Greenway Med. Supply Corp. v Travelers Ins. Co. (2017 NY Slip Op 51765(U)) Appellate Term, Second Department, December 15, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Sustained the EUO no-show dismissal after finding the insurer's affidavits established that the denial of claim form had been timely mailed.
Maxford, Inc. v Utica Mut. Ins. Co. (2017 NY Slip Op 51756(U)) Appellate Term, Second Department, December 15, 2017Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer showed prima facie that its denial on the EUO no-show ground was issued within 30 days of receiving the bills, and the provider failed to rebut that showing.
Sama Physical Therapy, P.C. v IDS Prop. Cas. Ins. Co. (2017 NY Slip Op 51751(U)) Appellate Term, Second Department, December 12, 2017No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it properly and timely denied two claims on the EUO no-show ground because its first scheduling letter went out more than 30 days after receipt; the third claim's denial remained timely under 65-3.8 (l).
St. Locher Med., P.C. v IDS Prop. Cas. Ins. Co. (2017 NY Slip Op 51732(U)) Appellate Term, Second Department, December 8, 2017Timely denial required as part of the no-show defense, and the insurer showed itHeld that omitting the dates of the scheduled examinations from the denial forms did not render the EUO no-show denials conclusory, vague or without merit.
Renelique Med. Servs., P.C. v Travelers Ins. Co. (2017 NY Slip Op 51728(U)) Appellate Term, Second Department, December 8, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established, as part of its EUO no-show defense, that the claims had been timely denied on that ground.
Pierre J. Renelique, M.D., P.C. v Travelers Ins. Co. (2017 NY Slip Op 51718(U)) Appellate Term, Second Department, December 8, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Sustained the EUO no-show dismissal after finding the insurer's proof sufficient to presume that its verification requests and denial of claim forms had been properly mailed.
Gentlecare Ambulatory Anesthesia Servs. v Geico Ins. Co. (2017 NY Slip Op 51518(U)) Appellate Term, Second Department, November 3, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show two duly demanded EUOs, two nonappearances and a timely denial, and found the denial of claim form shown to have been timely mailed.
TAM Med. Supply Corp. v 21st Century Ins. Co. (2017 NY Slip Op 51510(U)) Appellate Term, Second Department, November 3, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Sustained the EUO no-show dismissal after finding the insurer sufficiently established that the denial of claim forms had been timely mailed.
K.O. Med., P.C. v IDS Prop. Cas. Ins. Co. (2017 NY Slip Op 51454(U)) Appellate Term, Second Department, October 27, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment on two claims because it showed timely mailed EUO letters, two nonappearances and that the claims had been timely denied on that ground.
Sharp View Diagnostic Imaging, P.C. v Esurance (2017 NY Slip Op 51466(U)) Appellate Term, Second Department, October 27, 2017Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the insurer's letters did not toll its time to pay or deny, because they were EUO scheduling letters whose sufficiency the provider did not challenge, so the defense was not precluded.
NYS Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co. (2017 NY Slip Op 51263(U)) Appellate Term, Second Department, September 22, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment because it showed timely mailed IME letters, two nonappearances and that the claims had been timely denied on that ground.
Laga v Lancer Ins. Co. (2017 NY Slip Op 51244(U)) Appellate Term, Second Department, September 22, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Sustained the EUO no-show dismissal after finding the insurer's proof established proper mailing of its denials and verification requests.
Royal Med. Supply, Inc. v Nationwide Gen. Ins. Co. (2017 NY Slip Op 51235(U)) Appellate Term, Second Department, September 22, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Sustained the EUO no-show dismissal after rejecting the provider's challenge to the insurer's proof of mailing of the denial of claim forms.
LMS Acupuncture, P.C. v Titan Ins. Co. (2017 NY Slip Op 51229(U)) Appellate Term, Second Department, September 22, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of its denials of the claims underlying the fourth through sixth causes of action, leaving summary judgment on its EUO no-show defense undisturbed for those claims.
Sama Physical Therapy, P.C. v New York Cent. Mut. Fire Ins. Co. (2017 NY Slip Op 51186(U)) Appellate Term, Second Department, September 15, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Sustained the IME no-show dismissal after finding the insurer's proof sufficient to presume its denial of claim forms had been properly mailed.
LMS Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2017 NY Slip Op 51137(U)) Appellate Term, Second Department, September 8, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment because it showed timely mailed EUO letters, two nonappearances and that the claims had been timely denied on that ground.
Compas Med., P.C. v ELRAC, Inc. (2017 NY Slip Op 51019(U)) Appellate Term, Second Department, August 11, 2017Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge and held the insurer's proof gave rise to a presumption that its EUO no-show denials were timely mailed.
Elmont Rehab P.T., P.C. v New York Cent. Mut. Fire Ins. Co. (2017 NY Slip Op 50961(U)) Appellate Term, Second Department, July 21, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment because, besides the pre-claim IME letters and nonappearance, its moving papers established that it had timely denied the claims on that ground.
Greenway Med. Supply Corp. v Hartford Ins. Co. (2017 NY Slip Op 50960(U)) Appellate Term, Second Department, July 21, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment because it showed pre-claim IME letters, the assignor's nonappearance and that, upon receipt of the claims, it timely denied them on that ground.
Brand Med. Supply, Inc. v Praetorian Ins. Co. (2017 NY Slip Op 50947(U)) Appellate Term, Second Department, July 21, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment because its claims examiner's affidavit showed the denial based on the IME nonappearance was timely mailed, completing the defense.
Acupuncture Healthcare Plaza I, P.C. v Allstate Ins. Co. (2017 NY Slip Op 50939(U)) Appellate Term, Second Department, July 21, 2017No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld that because the follow-up EUO letter was untimely, the denial eventually sent was untimely, so the insurer was precluded from raising its EUO no-show defense.
Sovereigh Acupuncture, P.C. v American Commerce Ins. Co. (2017 NY Slip Op 50922(U)) Appellate Term, Second Department, July 14, 2017No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer failed to show it properly denied claims received in early 2012 on the EUO ground because its first scheduling letter was mailed more than 30 days after receipt and was a nullity.
St. Locher Med., P.C. v IDS Prop. Cas. Ins. Co. (2017 NY Slip Op 50919(U)) Appellate Term, Second Department, July 14, 2017No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer's moving papers did not demonstrate that the claims had been timely denied, an additional reason its EUO no-show defense failed on summary judgment.
Doctor Goldshteyn Chiropractic, P.C. v ELRAC, Inc. (2017 NY Slip Op 50923(U)) Appellate Term, Second Department, July 14, 2017Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the time to deny was not tolled, holding that the first EUO scheduling letter was timely mailed before the claims arrived, so the time to pay or deny was tolled.
First Class Med., P.C. v State Farm Mut. Auto. Ins. Co. (2017 NY Slip Op 50593(U)) Appellate Term, Second Department, April 27, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal with prejudice because the provider's appearance at an EUO is a condition precedent to liability and the insurer timely denied the claims on that ground.
Professional Health Imaging, P.C. v State Farm Mut. Auto. Ins. Co. (2017 NY Slip Op 50199(U)) Appellate Term, Second Department, February 8, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment because, besides mailing and nonappearance, it had timely denied the claims on the EUO no-show ground.
Longevity Med. Supply, Inc. v State Farm Fire & Cas. Co. (2017 NY Slip Op 50118(U)) Appellate Term, Second Department, January 20, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed it timely denied two claims on the EUO no-show ground, and the provider's statement that the bills remained outstanding did not rebut that entitlement to summary judgment.
National Med. & Surgical Supply, Inc. v ELRAC, Inc. (2017 NY Slip Op 50028(U)) Appellate Term, Second Department, January 5, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavits established that the denial of claim form based on the EUO no-show was timely mailed, as part of its showing for dismissal.
A.C. Med., P.C. v Ameriprise Ins. Co. (2016 NY Slip Op 51787(U)) Appellate Term, Second Department, December 7, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its EUO no-show defense because one claim was not denied in time after the second nonappearance, and late initial requests on the others were nullities that did not toll the 30 days.
Fontanella v Allstate Ins. Co. (2016 NY Slip Op 51679(U)) Appellate Term, Second Department, November 17, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show timely denials because its EUO letters were not sent within 30 days of receiving the claims and its delay letters did not toll the time, without reaching nonappearance.
Art of Healing Medicine, P.C. v Utica Mut. Ins. Co. (2016 NY Slip Op 51610(U)) Appellate Term, Second Department, November 1, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof raised a presumption that its denial forms on the EUO no-show ground were timely mailed, supporting dismissal.
Omphil Care, Inc. v Allstate Ins. Co. (2016 NY Slip Op 51602(U)) Appellate Term, Second Department, November 1, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer did not show it was not precluded from asserting its EUO no-show defense because it failed to establish that the denial of claim form was timely mailed.
Central Park Physical Medicine & Rehab., P.C. v National Liab. & Fire Ins. Co. (2016 NY Slip Op 51598(U)) Appellate Term, Second Department, October 31, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer did not show its 30-day period to pay or deny was tolled, because it did not prove timely mailing of the IME letters, so it made no prima facie showing on the IME no-show defense.
Renelique v Utica Mut. Ins. Co. (2016 NY Slip Op 51530(U)) Appellate Term, Second Department, October 13, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to demonstrate a proper and timely denial on the EUO no-show ground because its first EUO scheduling letter was sent 35 days after it received the claim.
Prime Diagnostic Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51523(U)) Appellate Term, Second Department, October 13, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof sufficient to presume that its denial of claim form, issued on the IME no-show ground, had been properly mailed, as part of the showing supporting dismissal.
EMA Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51428(U)) Appellate Term, Second Department, September 27, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof sufficient to presume proper mailing of its denial of claim forms on the IME no-show ground, supporting dismissal of the complaint.
Actual Chiropractic, P.C. v Mercury Cas. Co. (2016 NY Slip Op 51435(U)) Appellate Term, Second Department, September 27, 2016Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer proved its no-show denials were timely mailed and, rejecting the lower court's view, that omitting the scheduled exam dates did not make the denials conclusory or vague.
K.O. Med., P.C. v Allstate Ins. Co. (2016 NY Slip Op 51367(U)) Appellate Term, Second Department, September 19, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer's IME no-show motion also failed because its moving papers did not demonstrate timely mailing of the denial of claim forms.
Synergy First Med., P.L.L.C. v Allstate Ins. Co. (2016 NY Slip Op 51365(U)) Appellate Term, Second Department, September 19, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialApplying the rule that an EUO no-show defense requires a timely denial, held the insurer failed to establish that its denial of claim forms had been properly and timely mailed, so summary judgment was denied.
Ortho Passive Motion, Inc. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51364(U)) Appellate Term, Second Department, September 19, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that, upon receiving the requested verification, it timely denied the claims based on the assignor's IME nonappearance.
AVM Chiropractic, P.C. v 21st Century Ins. Co. (2016 NY Slip Op 51354(U)) Appellate Term, Second Department, September 19, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof sufficient to presume proper mailing of the denial of claim forms on the EUO no-show ground, rejecting the provider's challenge.
Restoration Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51325(U)) Appellate Term, Second Department, September 15, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's proof sufficient to presume proper mailing of its denial of claim forms, supporting its defense that the claims were timely denied for IME nonappearance.
Infinite Ortho Prods., Inc. v New York Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51320(U)) Appellate Term, Second Department, September 15, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Rejected the provider's challenge to proof that the denial of claim forms, based on IME nonappearance, had been timely and properly mailed, upholding dismissal.
TAM Med. Supply Corp. v American Tr. Ins. Co. (2016 NY Slip Op 51318(U)) Appellate Term, Second Department, September 15, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer's defense failed for one claim because it did not show the claim was denied within 30 days or that verification requests tolled its time, while the other claim was timely denied after tolling.
Vladenn Med. Supply Corp. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50928(U)) Appellate Term, Second Department, June 6, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applying the rule that the insurer must show a timely denial, held its affidavits established that the denial of claim forms on the EUO no-show ground were timely mailed.
New Quality Med., P.C. v Allstate Ins. Co. (2016 NY Slip Op 50871(U)) Appellate Term, Second Department, June 3, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer's EUO no-show defense unavailing because it failed to raise a triable issue that it had timely denied the claim, making its argument about triable issues on nonappearance irrelevant.
Professional Health Imaging, P.C. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50698(U)) Appellate Term, Second Department, April 25, 2016Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument against the denials' timeliness, holding the insurer properly tolled its time to pay the two claims through timely EUO requests and follow-ups, so the no-show defense was not precluded.
Pro Health Acupuncture, P.C. v Praetorian Ins. (2016 NY Slip Op 50380(U)) Appellate Term, Second Department, March 17, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the claims examiner's affidavit showed that the denial of claim forms based on the assignor's IME nonappearance were timely mailed, completing the no-show defense.
Alleviation Med. Servs., P.C. v Farmers New Century Ins. Co. (2016 NY Slip Op 50379(U)) Appellate Term, Second Department, March 17, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from asserting the IME no-show defense to one claim because it did not show the 30-day period was tolled, while the other claim, timely denied on that ground, was dismissed.
Great Health Care Chiropractic, P.C. v Unitrin Direct Ins. Co. (2016 NY Slip Op 50373(U)) Appellate Term, Second Department, March 16, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer not entitled to summary judgment on its IME no-show defense because its moving papers did not establish that it had timely denied the claim.
New Way Med. Supply Corp. v American Tr. Ins. Co. (2016 NY Slip Op 50370(U)) Appellate Term, Second Department, March 16, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer was entitled to dismissal because, after proving the EUO no-show, it timely denied the claims on that ground.
Ultimate Health Prods., Inc. v American Tr. Ins. Co. (2016 NY Slip Op 50330(U)) Appellate Term, Second Department, March 15, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held that since the insurer timely denied the claim on the EUO no-show ground, it demonstrated the assignor's breach of a condition precedent and was entitled to dismissal.
Bay LS Med. Supplies, Inc. v Allstate Ins. Co. (2016 NY Slip Op 50319(U)) Appellate Term, Second Department, March 11, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely and proper mailing of denial forms stating the EUO no-show ground, as part of the showing that entitled it to dismissal on its no-show defense.
Careplus Med. Supply, Inc. v Allstate Ins. Co. (2016 NY Slip Op 50196(U)) Appellate Term, Second Department, February 22, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its EUO no-show defense on one claim because it did not prove timely mailing of the follow-up EUO notice and so failed to show the time to deny was tolled.
Compas Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51776(U)) Appellate Term, Second Department, December 2, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed it timely denied the claims on the IME no-show ground, as one element of the defense that entitled it to dismissal of the remaining causes of action.
Delta Diagnostic Radiology, P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51711(U)) Appellate Term, Second Department, November 20, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, besides proving the EUO no-shows, it showed it had timely denied the claims on that ground.
Alleviation Med. Servs., P.C. v Esurance (2015 NY Slip Op 51715(U)) Appellate Term, Second Department, November 20, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denials, issued on the EUO no-show ground, were timely mailed, as part of the showing entitling it to dismissal.
Compas Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51699(U)) Appellate Term, Second Department, November 19, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely denied the claims on the IME/EUO no-show ground, one of the elements entitling it to summary judgment on the second through sixth causes of action.
New Quality Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51697(U)) Appellate Term, Second Department, November 19, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Listed the insurer's timely denial of the claims on the IME/EUO no-show ground among the elements it established in winning dismissal of six causes of action.
Compas Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51679(U)) Appellate Term, Second Department, November 13, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal on the IME no-show defense because, besides mailing and nonappearance, it showed it timely denied the claims on that ground.
Barakat Med. Care, P.C. v Nationwide Ins. Co. (2015 NY Slip Op 51677(U)) Appellate Term, Second Department, November 13, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show a timely denial as part of its EUO no-show case and found the denial forms were timely mailed.
Delta Diagnostic Radiology, P.C. v Country Wide Ins. Co. (2015 NY Slip Op 51672(U)) Appellate Term, Second Department, November 13, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed that its denial forms on the IME no-show ground were timely mailed, supporting dismissal on that defense.
Compas Med., P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51671(U)) Appellate Term, Second Department, November 13, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal of the claims because it showed it had timely denied them on the EUO no-show ground.
Active Chiropractic, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51668(U)) Appellate Term, Second Department, November 13, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because it showed both the EUO no-shows and that it had timely denied the claim on that ground.
Compas Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51667(U)) Appellate Term, Second Department, November 13, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from asserting the IME/EUO no-show defense for one claim because that claim was not denied within 30 days and no toll was shown; the other claims were timely denied.
Mind & Body Acupuncture, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51658(U)) Appellate Term, Second Department, November 12, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because it established that it had timely denied the claims after the IME and EUO no-shows.
Palafox PT, P.C. v State Farm Mut. Auto. Ins. Co. (2015 NY Slip Op 51653(U)) Appellate Term, Second Department, November 12, 2015Timely denial required as part of the no-show defense, and the insurer showed itApplied the rule requiring a timely denial as part of the EUO no-show case and rejected the provider's challenge, holding the denial forms were shown timely mailed.
New Way Med. Supply Corp. v Praetorian Ins. Co. (2015 NY Slip Op 51632(U)) Appellate Term, Second Department, November 9, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely denied the claim underlying the fourth cause of action on the IME/EUO no-show ground, an element of its no-show defense.
Ultimate Health Prods., Inc. v American Tr. Ins. Co. (2015 NY Slip Op 51592(U)) Appellate Term, Second Department, October 30, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because it showed both the EUO no-shows and that it had timely denied the claim on that ground.
Compas Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51467(U)) Appellate Term, Second Department, September 17, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely denied the claims on the IME/EUO no-show ground, one element of the defense that entitled it to dismissal of the remaining causes of action.
Healing Art Acupuncture, P.C. v Country Wide Ins. Co. (2015 NY Slip Op 51465(U)) Appellate Term, Second Department, September 17, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the IME no-show defense established for six causes of action whose denials were shown timely mailed, but not for the first cause of action because the insurer failed to establish as a matter of law that it timely denied that claim.
New Way Med. Supply Corp. v Company (2015 NY Slip Op 51461(U)) Appellate Term, Second Department, September 17, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because it showed both the IME no-show and timely mailing of denial forms that denied the claims on the no-show ground.
Metro Health Prods., Inc. v State Farm Mut. Auto. Ins. Co. (2015 NY Slip Op 51419(U)) Appellate Term, Second Department, September 17, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Rejected the provider's challenge to the mailing of the EUO no-show denial forms, holding them timely mailed, and upheld dismissal on the EUO no-show defense.
Compas Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51408(U)) Appellate Term, Second Department, September 16, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely denied the claims on the IME/EUO no-show ground, one element of the defense that entitled it to dismissal of the remaining causes of action.
Compas Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51403(U)) Appellate Term, Second Department, September 16, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely denied the claims underlying three causes of action on the IME/EUO no-show ground, an element of its no-show defense.
Hammond v Unitrin Advantage Ins. Co. (2015 NY Slip Op 51241(U)) Appellate Term, Second Department, August 6, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, besides the IME no-show, a claims representative's affidavit and affidavits of service showed timely mailing of denials based on the nonappearance.
Bay LS Med. Supplies, Inc. v Allstate Ins. Co. (2015 NY Slip Op 51229(U)) Appellate Term, Second Department, August 5, 2015Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer's unrebutted proof showed the EUO no-show denial was timely mailed, removing the only issue left for trial, so the cross motion for dismissal was granted.
Great Health Care Chiropractic, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51224(U)) Appellate Term, Second Department, August 5, 2015Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's appellate challenge and held the insurer's proof showed that the IME no-show denial was timely mailed and that the assignor failed to appear, so dismissal was proper.
Neptune Med. Care, P.C. v Ameriprise Auto & Home Ins. (2015 NY Slip Op 51220(U)) Appellate Term, Second Department, August 5, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer showed no toll because its EUO requests came more than 15 business days after receipt of the bills and were nullities, so the bills were not timely denied and the provider prevailed.
Starlite Acupuncture, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51209(U)) Appellate Term, Second Department, August 5, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denialGranted the provider judgment on two bills despite the insurer's EUO/IME no-show denials because the insurer failed to rebut that the bills were received earlier and not timely denied; a triable issue on timeliness remained for the third.
Arcadia Imaging, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 51208(U)) Appellate Term, Second Department, August 5, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, along with the IME no-show, its claims examiner's affidavit established timely mailing of the denial form.
Delta Diagnostic Radiology, P.C. v Esurance (2015 NY Slip Op 51212(U)) Appellate Term, Second Department, August 5, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, besides proving the EUO no-show, it showed it had timely denied the claims on that ground.
New Way Med. Supply Corp. v American Tr. Ins. Co. (2015 NY Slip Op 50809(U)) Appellate Term, Second Department, May 19, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because it showed the EUO no-show and that it timely denied the claims on that ground.
Great Health Care Chiropractic, P.C. v Esurance (2015 NY Slip Op 50807(U)) Appellate Term, Second Department, May 19, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, besides proving the EUO no-show, it showed it had timely denied the claims on that ground.
New Way Med. Supply Corp. v Praetorian Ins. Co. (2015 NY Slip Op 50780(U)) Appellate Term, Second Department, May 18, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because it showed the chiropractic IME no-show and that it timely denied the claims on that ground.
Delta Diagnostic Radiology, P.C. v Esurance (2015 NY Slip Op 50785(U)) Appellate Term, Second Department, May 18, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, besides proving the EUO no-show, it showed it had timely denied the claims on that ground.
Longevity Med. Supply, Inc. v Praetorian Ins. Co. (2015 NY Slip Op 50685(U)) Appellate Term, Second Department, May 1, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal on the EUO no-show defense, finding among its elements that the denial forms were timely mailed.
Metro Psychological Servs., P.C. v 21st Century N. Am. Ins. Co. (2015 NY Slip Op 50470(U)) Appellate Term, Second Department, April 7, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal on the EUO no-show defense, finding among its elements that the denial form was timely mailed.
T & J Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2015 NY Slip Op 50406(U)) Appellate Term, Second Department, March 17, 2015Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge to the mailing of the EUO no-show denial forms, holding them timely mailed, and upheld dismissal.
Metro Health Prods., Inc. v State Farm Mut. Auto. Ins. Co. (2015 NY Slip Op 50402(U)) Appellate Term, Second Department, March 17, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Rejected the provider's challenge to the mailing of the EUO no-show denial forms, holding them timely mailed, and upheld dismissal.
Performance Plus Med., P.C. v Utica Mut. Ins. Co. (2015 NY Slip Op 50399(U)) Appellate Term, Second Department, March 16, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the scheduling letters tolled the time to pay or deny where necessary and the claims were timely denied on the EUO/IME no-show ground; failure to send the denial in duplicate is not fatal.
Tong Li v Praetorian Ins. Co. (2015 NY Slip Op 50397(U)) Appellate Term, Second Department, March 16, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer made its prima facie no-show showing, including timely mailing of denials based on the IME nonappearance.
Cortland Med. Supply, P.C. v Praetorian Ins. Co. (2015 NY Slip Op 50394(U)) Appellate Term, Second Department, March 16, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal because, along with the IME no-show, its claims examiner's affidavit showed timely mailing of denials based on the nonappearance.
Longevity Med. Supply, Inc. v Praetorian Ins. Co. (2015 NY Slip Op 50393(U)) Appellate Term, Second Department, March 16, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the IME no-show defense established where, besides mailing and nonappearance, the claims examiner's affidavit showed the denial based on the nonappearance was timely mailed.
Avicenna Med. Arts, PLLC v Unitrin Advantage Ins. Co. (2015 NY Slip Op 50382(U)) Appellate Term, Second Department, March 12, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its EUO no-show defense because its untimely follow-up requests did not toll the 30 days and the claims were not denied within 30 days of receipt.
Ultimate Health Prods., Inc. v Travelers Ins. Co. (2015 NY Slip Op 50377(U)) Appellate Term, Second Department, March 12, 2015Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the EUO no-show defense established where the insurer showed both the nonappearances and that its denial forms were timely mailed.
Power Supply, Inc. v Praetorian Ins. Co. (2015 NY Slip Op 50218(U)) Appellate Term, Second Department, February 24, 2015Timely denial required as part of the no-show defense, and the insurer showed itHeld the denials timely because issued within 30 days after the assignor's last EUO nonappearance, even though the IME nonappearances occurred over 30 days earlier, so the insurer was not precluded.
XVV, Inc. v Praetorian Ins. Co. (2014 NY Slip Op 51862(U)) Appellate Term, Second Department, December 19, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the no-show defense established for the first claim, which was timely denied, but not for the second, because the insurer failed to establish as a matter of law that it timely denied that claim.
Right Solution Med. Supply, Inc. v NY Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 51860(U)) Appellate Term, Second Department, December 19, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed it timely denied the claims on the IME no-show ground after receiving the requested additional verification, supporting dismissal of two causes of action.
Coney Is. Physician Care, P.C. v Praetorian Ins. Co. (2014 NY Slip Op 51859(U)) Appellate Term, Second Department, December 19, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of its denials on the IME no-show ground, together with mailing and nonappearance proof, entitling it to dismissal of the remaining claims.
Compas Med., P.C. v Nationwide Ins. (2014 NY Slip Op 51824(U)) Appellate Term, Second Department, December 17, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer entitled to dismissal on its IME/EUO no-show defense because it also showed that its denials on that ground were timely mailed.
True-Align Chiropractic Care, P.C. v Country Wide Ins. Co. (2014 NY Slip Op 51821(U)) Appellate Term, Second Department, December 17, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavit established timely and proper mailing of its denials, rejecting the provider's challenge, while the IME no-show defense defeated the remaining causes of action.
Utopia Equip., Inc. v NY Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 51820(U)) Appellate Term, Second Department, December 17, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the IME no-show defense established for two timely denied claims but not for two others, which the insurer failed to show were timely denied.
All About Rehabilitation & P.T., P.C. v Praetorian Ins. Co. (2014 NY Slip Op 51815(U)) Appellate Term, Second Department, December 17, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the IME no-show defense established where, besides mailing and nonappearance, the litigation examiner's affidavit established timely mailing of the denials.
Excel Imaging, P.C. v Infinity Select Ins. Co. (2014 NY Slip Op 51796(U)) Appellate Term, Second Department, December 17, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the EUO no-show defense established where the EUO letters tolled the time to deny and the claim was timely and properly denied on the nonappearance ground.
MML Med. Care, P.C. v Praetorian Ins. Co. (2014 NY Slip Op 51792(U)) Appellate Term, Second Department, December 17, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely mailed denial of claim forms denying the claims on the EUO no-show ground, as part of its prima facie showing.
All Boro Psychological Servs., P.C. v State Farm Mut. Auto. Ins. Co. (2014 NY Slip Op 51787(U)) Appellate Term, Second Department, December 11, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavits established that the denial of claim forms based on the EUO nonappearance had been timely mailed, supporting dismissal.
Lotus Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2014 NY Slip Op 51315(U)) Appellate Term, Second Department, August 20, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer submitted sufficient proof that the denial of claim form based on the EUO nonappearance had been timely mailed.
Natural Therapy Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2014 NY Slip Op 51310(U)) Appellate Term, Second Department, August 20, 2014Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer's affidavits established that the denial of claim forms based on the EUO nonappearance were timely mailed under standard office practice, upholding dismissal.
Arco Med. NY, P.C. v AIG Indem. Ins. Co. (2014 NY Slip Op 51257(U)) Appellate Term, Second Department, August 8, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavits sufficiently demonstrated that it timely denied the claims based on the IME nonappearance, as an element of its defense.
Quality Psychological Servs., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 51256(U)) Appellate Term, Second Department, August 8, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the claims examiner's affidavit showed the denial based on the IME nonappearance was timely mailed, completing the insurer's defense.
Longevity Med. Supply, Inc. v IDS Prop. & Cas. Ins. Co. (2014 NY Slip Op 51244(U)) Appellate Term, Second Department, July 28, 2014Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's untimeliness argument, computing that late initial EUO requests only shortened the time to deny and that the denials, mailed 11 days after the final nonappearance or within 30 days of receipt, were timely.
Optimal Well-Being Chiropractic, P.C. v Utica Mut. Ins. Co. (2014 NY Slip Op 51233(U)) Appellate Term, Second Department, July 28, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer not entitled to summary judgment on its IME no-show defense because it failed to establish that the defense was not precluded, treating it as subject to the timely-denial rule.
By MD, P.C. v NY Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 51232(U)) Appellate Term, Second Department, July 28, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the claims examiner's affidavit sufficiently described standard mailing practices for the denial forms, supporting the insurer's timely denial on the IME no-show ground.
Hillside OpenMRI, P.C. v Allstate Ins. Co. (2014 NY Slip Op 51143(U)) Appellate Term, Second Department, July 7, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialGranted the EUO no-show defense on one claim that was timely denied, but held another claim not shown timely denied because delay letters pending an EUO did not toll the 30 days.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50963(U)) Appellate Term, Second Department, May 29, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialDismissed 13 claims on timely mailed IME no-show denials but held the insurer failed to show timely denial of one claim, denied over two months after the second no-show, as its letters were not verification requests.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50960(U)) Appellate Term, Second Department, May 29, 2014Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer established timely mailing of its IME no-show denials, the only issue left for trial, and so granted dismissal.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50954(U)) Appellate Term, Second Department, May 29, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's contention that the IME no-show defense survives regardless of denial timeliness, holding it subject to preclusion and leaving a question of fact as to timely denial.
J.C. Healing Touch Rehab, P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50635(U)) Appellate Term, Second Department, April 7, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the litigation examiner's affidavit established timely mailing of the IME no-show denials, supporting dismissal.
Active Chiropractic, P.C. v Praetorian Ins. Co. (2014 NY Slip Op 50634(U)) Appellate Term, Second Department, April 7, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of its denial of claim form, together with the EUO letters, supporting its no-show defense.
Village Med. Supply, Inc. v NY Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50631(U)) Appellate Term, Second Department, April 7, 2014Timely denial required as part of the no-show defense, and the insurer showed itHeld claims received after the assignor's IME no-shows were timely denied, one within 30 days of receipt and the other within 30 days of receiving requested verification under a compliant follow-up request.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50472(U)) Appellate Term, Second Department, March 17, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's contention that its IME no-show defense was immune from preclusion, holding it precluded for the claims whose timely denial was not established, while granting dismissal of claims shown timely denied.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50471(U)) Appellate Term, Second Department, March 17, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's contention that its IME no-show defense survived regardless of the denial, holding the defense subject to preclusion for claims not shown timely denied, while dismissing claims proved timely denied.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50468(U)) Appellate Term, Second Department, March 17, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's argument that its IME no-show defense was not precludable, holding the defense subject to preclusion if the denial was untimely and that a fact question on timely denial barred summary judgment.
Eagle Surgical Supply, Inc. v Allstate Fire & Cas. Ins. Co. (2014 NY Slip Op 50464(U)) Appellate Term, Second Department, March 17, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer did not show it was not precluded from its EUO no-show defense, because without proof of when it received the claims it could not show tolling or a timely denial.
Right Aid Med. Supply Corp. v Utica Mut. Ins. Co. (2014 NY Slip Op 50421(U)) Appellate Term, Second Department, March 11, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that the EUO letters tolled its time and that it timely denied the claims on the no-show ground, so its defense succeeded.
Clinton Place Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2014 NY Slip Op 50413(U)) Appellate Term, Second Department, March 11, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's argument that its IME no-show defense entitled it to judgment on claims it never showed it denied, holding the defense subject to preclusion absent a timely denial.
Bay Ls Med. Supplies, Inc. v Mvaic (2014 NY Slip Op 50417(U)) Appellate Term, Second Department, March 11, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld MVAIC precluded from its IME no-show defense because the scheduling letters were mailed more than 30 days after receipt of the claim, and in any event its general denial did not specifically deny the bill.
Clove Med. Supply, Inc. v Ameriprise Ins. Co. (2014 NY Slip Op 50357(U)) Appellate Term, Second Department, February 28, 2014No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it tolled its time to pay or deny, and thus that it was not precluded from its EUO no-show defense, because receipt dates of the claims were not shown.
Natural Therapy Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2014 NY Slip Op 50134(U)) Appellate Term, Second Department, January 28, 2014Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge to the denials and held the insurer's affidavits established that its denials on the EUO no-show ground were timely mailed.
Concourse Chiropractic, PLLC v State Farm Mut. Ins. Co. (2013 NY Slip Op 52225(U)) Appellate Term, Second Department, December 20, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer demonstrated that the claims were timely denied based on the provider's nonappearance at the EUOs, supporting dismissal of those causes of action.
Olmeur Med., P.C. v Nationwide Gen. Ins. Co. (2013 NY Slip Op 52031(U)) Appellate Term, Second Department, December 3, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavits together established timely mailing of denial forms based on the assignor's failure to appear at the EUOs.
Art of Healing Medicine, P.C. v Amica Mut. Ins. Co. (2013 NY Slip Op 52014(U)) Appellate Term, Second Department, November 29, 2013Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer conditionally entitled to dismissal on its IME no-show defense once it files a conforming certificate for the affidavit showing its denials were timely mailed.
J.C. Healing Touch Rehab, P.C. v Nationwide Ins. (2013 NY Slip Op 52011(U)) Appellate Term, Second Department, November 26, 2013Timely denial required as part of the no-show defense, and the insurer showed itHeld the EUO no-show denials timely because the EUO scheduling letters themselves tolled the claim determination period, rejecting the provider's argument that the delay letters could not toll it.
Arco Med. NY, P.C. v Metropolitan Cas. Ins. Co. (2013 NY Slip Op 52001(U)) Appellate Term, Second Department, November 26, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed it denied four claims within 30 days of receipt on the EUO no-show ground, entitling it to dismissal of those claims.
Vit Acupuncture, P.C. v Praetorian Ins. Co. (2013 NY Slip Op 52000(U)) Appellate Term, Second Department, November 26, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the claims examiner's affidavit showed the denials based on the IME nonappearance were timely mailed, completing the insurer's entitlement to dismissal.
Dream Acupuncture, P.C. v State Farm Fire & Cas. Co. (2013 NY Slip Op 51997(U)) Appellate Term, Second Department, November 26, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavits sufficiently proved mailing of its denials based on the EUO nonappearance, supporting its claim that the claims were timely denied.
Eagle Surgical Supply, Inc. v Allstate Indem. Co. (2013 NY Slip Op 52012(U)) Appellate Term, Second Department, November 26, 2013Timely denial required as part of the no-show defense, and the insurer showed itHeld the denial timely: the late first EUO request reduced the time to deny to 21 days, and the denial was mailed 20 days after the final EUO nonappearance.
Ortho Prods. & Equip., Inc. v Interboro Ins. Co. (2013 NY Slip Op 52054(U)) Appellate Term, Second Department, November 21, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that it timely denied the claims on the ground that the assignors failed to appear for EUOs.
Megacure Acupuncture, P.C. v Lancer Ins. Co. (2013 NY Slip Op 51994(U)) Appellate Term, Second Department, November 21, 2013No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its defenses on three claims it neither paid nor denied within 30 days, with no EUO pending and a late, insufficient delay letter, but not precluded on the others, which it timely denied on the EUO no-show ground.
Flatbush Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2013 NY Slip Op 51880(U)) Appellate Term, Second Department, October 29, 2013Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge to the EUO no-show denials, holding the insurer's affidavits established that the denial of claim forms had been timely mailed under its standard office practice.
Barclays Med., P.C. v NY Cent. Mut. Fire Ins. Co. (2013 NY Slip Op 51758(U)) Appellate Term, Second Department, October 15, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer showed that its denial of claim forms based on the IME nonappearance had been timely mailed to the provider's address, completing its no-show defense.
Right Aid Med. Supply Corp. v Nationwide Ins. (2013 NY Slip Op 51746(U)) Appellate Term, Second Department, October 15, 2013No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer lost the toll from its EUO requests because its follow-up delay notice did not identify the party from whom the EUO was requested, so the denial was not shown timely and summary judgment was denied.
Compas Med., P.C. v Elrac, Inc. (2013 NY Slip Op 51734(U)) Appellate Term, Second Department, October 8, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's claims examiner sufficiently described standard mailing practices for the denial forms, completing its IME no-show defense alongside proof of mailed scheduling letters and nonappearance.
Canarsie Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2013 NY Slip Op 51457(U)) Appellate Term, Second Department, August 26, 2013Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the EUO no-show denials were not proved timely mailed, holding the insurer's affidavits established that the denial of claim forms had been timely mailed.
Right Aid Diagnostic Medicine, P.C. v Travelers Ins. Co. (2013 NY Slip Op 51033(U)) Appellate Term, Second Department, June 17, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer showed that its denial of claim forms, based on the assignor's IME nonappearance, had been timely mailed, as part of its prima facie showing.
Avenue I Med., P.C. v Hertz (2013 NY Slip Op 50840(U)) Appellate Term, Second Department, May 13, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denials based on the IME nonappearance had been timely mailed, completing its no-show defense.
Art of Healing Medicine, P.C. v New York Cent. Mut. Fire Ins. Co. (2013 NY Slip Op 50766(U)) Appellate Term, Second Department, May 6, 2013No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's argument that the IME no-show was a breach of a condition precedent to coverage, because it concededly never denied the claim on that ground.
Flatlands Med., P.C. v State Farm Mut. Auto. Ins. Co. (2013 NY Slip Op 50763(U)) Appellate Term, Second Department, May 6, 2013Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the insurer did not prove mailing of its denials, holding the denial of claim forms based on the EUO nonappearance had been timely mailed.
Compas Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2013 NY Slip Op 50762(U)) Appellate Term, Second Department, May 6, 2013No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer, having failed to prove timely mailing of its denials, did not establish it was not precluded from its defense that the assignor failed to comply with a condition precedent to coverage.
Flatbush Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2013 NY Slip Op 50758(U)) Appellate Term, Second Department, May 6, 2013Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the insurer failed to prove mailing of its denials, holding the denial of claim forms on the EUO no-show ground had been timely mailed.
Five Boro Psychological Servs., P.C. v State Farm Mut. Auto. Ins. Co. (2013 NY Slip Op 50753(U)) Appellate Term, Second Department, May 6, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer's affidavits established that its denial of claim form had been timely mailed, as part of upholding its EUO no-show defense.
Alev Med. Supply, Inc. v New York Cent. Mut. Fire Ins. Co. (2013 NY Slip Op 50258(U)) Appellate Term, Second Department, February 19, 2013Timely denial required as part of the no-show defense, and the insurer showed itHeld the IME no-show denials timely because written verification requests tolled the time until the verification arrived, so denials within 30 days thereafter were timely despite coming over 45 days after the last nonappearance.
Compas Med., P.C. v Farm Family Cas. Ins. Co. (2013 NY Slip Op 50254(U)) Appellate Term, Second Department, February 19, 2013No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from asserting the EUO no-show defense to eight claims because its denials on that ground were untimely, following the Second Department rather than the First Department rule.
Infinity Health Prods., Ltd. v Travelers Ins. Co. (2013 NY Slip Op 50253(U)) Appellate Term, Second Department, February 19, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the last bill was timely and properly denied, within 30 days of receipt under 65-3.8 (a), on the ground of the provider's earlier nonappearance at two properly scheduled EUOs.
Compas Med., P.C. v Praetorian Ins. Co. (2013 NY Slip Op 50251(U)) Appellate Term, Second Department, February 19, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Required and found proof that the denials based on the IME nonappearance were timely mailed as part of the insurer's no-show defense, which entitled it to dismissal of those claims.
Compas Med., P.C. v Praetorian Ins. Co. (2013 NY Slip Op 50249(U)) Appellate Term, Second Department, February 19, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted dismissal of the IME no-show claims after finding the insurer showed its denials on that ground were timely mailed, along with mailing of scheduling letters and nonappearance.
Flatlands Med., P.C. v State Farm Mut. Auto. Ins. Co. (2013 NY Slip Op 50071(U)) Appellate Term, Second Department, January 14, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer's affidavits established that its denial of claim forms had been timely mailed, as part of upholding its EUO no-show defense.
Eastern Star Acupuncture, P.C. v American Tr. Ins. Co. (2013 NY Slip Op 50059(U)) Appellate Term, Second Department, January 14, 2013No-show defense is subject to preclusion and fails for want of a timely, proper denialGranted the insurer dismissal of claims it showed were timely denied on the IME no-show ground, but left judgment for the provider on claims the insurer failed to show, or conceded it did not, timely deny.
Brooklyn Hgts. Physical Therapy, P.C. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 52406(U)) Appellate Term, Second Department, December 21, 2012Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer's no-show denials timely mailed and valid, rejecting the finding that they were nullities for not being issued in duplicate since copies went to the provider, assignor and attorney.
Essential Acupuncture Servs., P.C. v Ameriprise Auto & Home Ins. (2012 NY Slip Op 52404(U)) Appellate Term, Second Department, December 21, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld that without proof the EUO letters were timely mailed the 30-day period was not tolled, so the insurer did not show its denials were timely or that it was not precluded from the no-show defense.
Parsons Med. Supply, Inc. v Utica Mut. Ins. Co. (2012 NY Slip Op 52397(U)) Appellate Term, Second Department, December 21, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it was not precluded from its EUO no-show defense because, without proof of timely initial and follow-up EUO requests, it did not establish that its time to pay or deny was tolled.
Essential Acupuncture Servs., P.C. v Amex Assur. Co. (2012 NY Slip Op 52259(U)) Appellate Term, Second Department, December 7, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not shown its EUO no-show defense was not precluded for two claims, which it admittedly received and did not deny within 30 days with no EUOs pending; a third claim was timely denied.
Morris Med., P.C. v Amex Assur. Co. (2012 NY Slip Op 52260(U)) Appellate Term, Second Department, December 7, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not shown its EUO no-show defense was not precluded for five claims neither paid nor denied within 30 days with no EUO pending, but found the other six claims timely denied.
Arco Med. NY, P.C. v Lancer Ins. Co. (2012 NY Slip Op 52178(U)) Appellate Term, Second Department, November 26, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer not precluded from its EUO no-show defense because it showed the claim had been denied on that ground after timely mailed EUO requests and the principals' nonappearance.
Infinity Health Prods., Ltd. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 51955(U)) Appellate Term, Second Department, October 16, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial of claim forms were timely mailed as part of its prima facie IME no-show defense.
Rainbow Med. Care, P.C. v Kemper Ins. Co. (2012 NY Slip Op 51923(U)) Appellate Term, Second Department, October 5, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denials based on the IME nonappearance were timely mailed, as part of its no-show defense.
All Boro Psychological Servs., P.C. v Hartford Ins. Co. (2012 NY Slip Op 51849(U)) Appellate Term, Second Department, September 19, 2012Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's challenge and held the insurer's affidavits established the EUO no-show denial was timely mailed.
Arco Med. N.Y., P.C. v Lancer Ins. Co. (2012 NY Slip Op 22278) Appellate Term, Second Department, September 19, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not shown its EUO no-show defense was not precluded as to two claims, because they were neither paid nor denied within 30 days and a delay letter did not toll the time; later claims were timely denied.
Jamaica Med. Supply, Inc. v Encompass Indem. Co. (2012 NY Slip Op 51825(U)) Appellate Term, Second Department, September 13, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of its denials based on the assignors' EUO nonappearances as part of its successful no-show defense.
BLR Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 51770(U)) Appellate Term, Second Department, September 5, 2012Timely denial required as part of the no-show defense, and the insurer showed itReversed the finding that the denial's timeliness was triable, holding the litigation examiner's affidavit showed the EUO no-show denial was timely mailed, so the insurer won.
Atlantic Radiology Imaging, P.C. v NY Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 51725(U)) Appellate Term, Second Department, August 31, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's employee affidavit showed the denial of claim forms were timely mailed as part of its IME no-show defense.
Brooklyn Hgts. Physical Therapy, P.C. v Liberty Mut. Fire Ins. Co. (2012 NY Slip Op 51712(U)) Appellate Term, Second Department, August 31, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the claim specialist's affidavit showed the IME no-show denials were timely mailed, which, with the other proof, raised a triable issue defeating the provider's motion.
Neomy Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 51653(U)) Appellate Term, Second Department, August 24, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the litigation examiner's affidavit showed the insurer timely denied the claims based on the IME nonappearance, as part of its prima facie no-show defense.
Jamhil Med., P.C. v Clarendon Natl. Ins. Co. (2012 NY Slip Op 51644(U)) Appellate Term, Second Department, August 23, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the claims examiner's affidavit showed the insurer timely denied the claim on the IME no-show ground, as part of its entitlement to dismissal.
All Star Wellness Med., P.C. v Praetorian Ins. Co. (2012 NY Slip Op 51630(U)) Appellate Term, Second Department, August 7, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer properly denied the bills on the IME no-show ground and therefore was not precluded from raising that defense.
Quality Psychological Servs., P.C. v Interboro Mut. Indem. Ins. Co. (2012 NY Slip Op 51628(U)) Appellate Term, Second Department, August 7, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's affidavits established the denial of claim form was timely mailed, as part of its EUO no-show defense.
Jamaica Dedicated Med. Care, P.C. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 51493(U)) Appellate Term, Second Department, August 6, 2012Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's contentions and held the insurer's affidavits sufficed to show its EUO no-show denials were timely and properly mailed.
J.M. Chiropractic Servs., PLLC v State Farm Mut. Ins. Co. (2012 NY Slip Op 51348(U)) Appellate Term, Second Department, July 13, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld that without proof the EUO letters were timely mailed the 30-day period was not tolled, so the insurer failed to show its denial was timely and that it was not precluded from the no-show defense.
All Boro Psychological Servs., P.C. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 51346(U)) Appellate Term, Second Department, July 13, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's EUO no-show defense established, including proof that the denial of claim form had been timely mailed, as part of the elements it had to show.
Brooklyn Hgts. Physical Therapy, P.C. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 51337(U)) Appellate Term, Second Department, July 12, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its IME no-show defense because its untimely follow-up IME letter did not toll the 30-day period, making its denials untimely.
Alev Med. Supply, Inc. v Allstate Prop. & Cas. Ins. Co. (2012 NY Slip Op 51294(U)) Appellate Term, Second Department, June 28, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Rejected the insurer's alternative EUO no-show ground because it failed to show it timely denied the claims on that ground, and so failed to show it was not precluded from asserting the defense.
Mega Supplies Billing, Inc. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 51276(U)) Appellate Term, Second Department, June 27, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denial forms, based on the EUO nonappearance, had been timely mailed, as part of its successful no-show defense.
Colonia Med., P.C. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 51273(U)) Appellate Term, Second Department, June 27, 2012Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer established timely mailing of denial forms based on the EUO nonappearance, rejecting the provider's argument that the denials were not shown timely mailed.
Mega Supplies Billing, Inc. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 51269(U)) Appellate Term, Second Department, June 27, 2012Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer established that its denial forms, based on the EUO nonappearance, had been timely mailed, rejecting the provider's challenge.
Tsatskis v State Farm Fire & Cas. Co. (2012 NY Slip Op 51268(U)) Appellate Term, Second Department, June 27, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its EUO no-show defense on 14 claims because the first EUO request came more than 30 days after receipt of 13 claims and the denial of the 14th was untimely, but found denials of two later claims timely.
VE Med. Care, P.C. v NY Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 51074(U)) Appellate Term, Second Department, June 11, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial, based on the IME nonappearance, had been timely mailed, as part of its prima facie no-show defense.
Concourse Chiropractic, PLLC v Fiduciary Ins. Co. of Am. (2012 NY Slip Op 51058(U)) Appellate Term, Second Department, June 11, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show defense failed because the untimely follow-up EUO request did not toll the 30-day period, so the denial was untimely.
Midwood Total Rehabilitation Med., P.C. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 50931(U)) Appellate Term, Second Department, May 15, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial forms, based on the IME nonappearance, had been timely mailed, as part of its prima facie no-show defense.
Leica Supply, Inc. v Encompass Indem. Co. (2012 NY Slip Op 50890(U)) Appellate Term, Second Department, May 14, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of its denial based on the EUO nonappearance, and rejected the argument that the no-show permitted denial only of pending claims.
Mega Supplies Billing, Inc. v State Farm Fire & Cas. Co. (2012 NY Slip Op 51014(U)) Appellate Term, Second Department, May 14, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of its denials based on the provider's EUO nonappearance as part of its successful no-show defense.
BR Clinton Chiropractic, P.C. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 50880(U)) Appellate Term, Second Department, May 11, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Required proof of timely mailed no-show denials; found them proved for four claims but not for the remaining claim, whose denial the litigation examiner's affidavit did not address, so summary judgment was limited to four claims.
Axis Chiropractic, PLLC v Clarendon Natl. Ins. Co. (2012 NY Slip Op 50753(U)) Appellate Term, Second Department, April 25, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial forms, based on the IME nonappearances, had been timely mailed, as part of its successful no-show defense.
Quality Psychological Servs., P.C. v MVAIC (2012 NY Slip Op 50757(U)) Appellate Term, Second Department, April 25, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established that its denials based on the IME nonappearance were timely mailed, as part of its successful no-show defense.
Viviane Etienne Med. Care, P.C. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 50579(U)) Appellate Term, Second Department, April 2, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of the denial forms as part of its successful EUO no-show defense.
East 75th St. Diagnostic Imaging, P.C. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 50564(U)) Appellate Term, Second Department, March 28, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer sufficiently established timely mailing of the denial forms as part of its successful IME no-show defense.
Superior Oxygen & Ortho Supplies, Ltd. v Auto One Ins. Co. (2012 NY Slip Op 50348(U)) Appellate Term, Second Department, February 21, 2012No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from raising the EUO no-show defense because it did not show the scheduling letters were timely mailed or the 30 days tolled, so its denials were not shown timely.
Arco Med. NY, P.C. v Lancer Ins. Co. (2011 NY Slip Op 52384(U)) Appellate Term, Second Department, December 23, 2011No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer had not shown its EUO no-show defense was not precluded for two claims, which it received and neither paid nor denied within 30 days, as its late delay letter did not toll the time.
Arco Med. NY, P.C. v Lancer Ins. Co. (2011 NY Slip Op 52383(U)) Appellate Term, Second Department, December 23, 2011No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its EUO no-show defense because its earlier denial predated the claims at issue and it did not prove mailing of the later denials, rejecting treatment of the no-show as a non-precludable coverage defense.
ARCO Med. N.Y., P.C. v Lancer Ins. Co. (2011 NY Slip Op 52382(U)) Appellate Term, Second Department, December 23, 2011Timely denial required as part of the no-show defense, and the insurer showed itHeld the EUO no-show denial timely for all claims, the EUO request tolling even claims received later until the second nonappearance, so the condition-precedent defense was not precluded.
Alrof, Inc. v Country Wide Ins. Co. (2011 NY Slip Op 52297(U)) Appellate Term, Second Department, December 19, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed that its time to pay or deny one claim was tolled and that it timely denied it on the IME no-show ground, which raised a triable issue defeating the provider's motion.
Quality Psychological Servs., P.C. v Auto One Ins. Co. (2011 NY Slip Op 52281(U)) Appellate Term, Second Department, December 16, 2011No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the IME no-show defense precluded because the insurer did not establish timely mailing of the denial based on the nonappearance.
Neomy Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2011 NY Slip Op 52279(U)) Appellate Term, Second Department, December 16, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer showed its denial forms, based on the IME nonappearance, had been timely mailed, as part of its prima facie no-show defense.
Eastern Star Acupuncture, P.C. v American Tr. Ins. Co. (2011 NY Slip Op 52205(U)) Appellate Term, Second Department, December 5, 2011No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the IME no-show defense precluded for one claim because the insurer's denial form actually denied it on an IME report, not on the assignor's failure to appear.
Park Slope Med. v Praetorian Ins. Co. (2011 NY Slip Op 52062(U)) Appellate Term, Second Department, November 4, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer not precluded because it timely mailed denials based on the IME nonappearance after receiving requested verification, applying the preclusion rule.
Padova Physical Rehab. Medicine, P.C. v Praetorian Ins. Co. (2011 NY Slip Op 51862(U)) Appellate Term, Second Department, October 14, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer not precluded from its IME no-show defense because it showed timely mailing of the denials based on the nonappearance, applying the preclusion rule.
Proscan Imaging Buffalo v Clarendon Natl. Ins. Co. (2011 NY Slip Op 51855(U)) Appellate Term, Second Department, October 12, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer not precluded from its IME no-show defense because it showed timely mailing of the denials based on the nonappearance, applying the preclusion rule.
Triangle R, Inc. v Clarendon Natl. Ins. Co. (2011 NY Slip Op 51854(U)) Appellate Term, Second Department, October 12, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer not precluded from its IME no-show defense because it showed timely mailing of the denial based on the nonappearance, applying the preclusion rule.
Parkway Imaging & Diagnostic, P.C. v Clarendon Natl. Ins. Co. (2011 NY Slip Op 51853(U)) Appellate Term, Second Department, October 12, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer not precluded from its IME no-show defense because it showed timely mailing of the denial based on the nonappearance, applying the preclusion rule.
Five Boro Psychological Servs., P.C. v State Farm Mut. Auto. Ins. Co. (2011 NY Slip Op 51846(U)) Appellate Term, Second Department, October 11, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment on the EUO no-show defense after finding, among its elements, that the denial of claim form based on the nonappearance was timely mailed.
Fiutek v Clarendon Natl. Ins. Co. (2011 NY Slip Op 51840(U)) Appellate Term, Second Department, October 11, 2011No-show defense is subject to preclusion and fails for want of a timely, proper denialDenied the insurer summary judgment on one IME no-show claim because its affidavit left an issue of fact whether that denial was timely mailed, while granting it on claims whose denials were shown timely mailed.
Vincent Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co. (2011 NY Slip Op 51718(U)) Appellate Term, Second Department, September 16, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer was not precluded from its IME no-show defense because its denials on that ground were shown timely mailed under its standard office practices.
Shoreline Healing Acupuncture Group, P.C. v American Tr. Ins. Co. (2011 NY Slip Op 51531(U)) Appellate Term, Second Department, August 4, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment on the IME no-show defense after finding, among its elements, that the denial of claim forms were timely mailed.
Alrof, Inc. v Nationwide Ins. Co. (2011 NY Slip Op 51451(U)) Appellate Term, Second Department, July 28, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted summary judgment on the IME no-show defense after finding the denials on that ground timely mailed, following the Second Department preclusion rule while noting the contrary First Department view.
Corona Hgts. Med., P.C. v Lancer Ins. Co. (2011 NY Slip Op 51293(U)) Appellate Term, Second Department, July 5, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Upheld dismissal on the EUO no-show defense after finding, among its elements, that the denial based on the nonappearance was timely mailed.
Manhattan Med. Imaging, P.C. v New York Cent. Mut. Fire Ins. Co. (2011 NY Slip Op 51230(U)) Appellate Term, Second Department, June 30, 2011Timely denial required as part of the no-show defense, and the insurer showed itReversing the lower court's finding of an untimely denial, held the insurer established it timely denied the claim on the IME no-show ground through proof of when its IME notices were sent.
East Coast Acupuncture, P.C. v Clarendon Natl. Ins. Co. (2011 NY Slip Op 51229(U)) Appellate Term, Second Department, June 30, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted summary judgment on the claims denied for the IME no-show after finding the denial forms timely mailed.
All Borough Group Med. Supply, Inc. v Utica Mut. Ins. Co. (2011 NY Slip Op 50949(U)) Appellate Term, Second Department, May 23, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer not precluded from its IME no-show defense because it properly and timely denied the claim on that ground, following the Second Department rule rather than the First Department's.
Crescent Radiology, PLLC v American Tr. Ins. Co. (2011 NY Slip Op 50622(U)) Appellate Term, Second Department, April 6, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment on its EUO no-show defense after finding, among its elements, that the denial of claim forms were timely mailed.
All County, LLC v Unitrin Advantage Ins. Co. (2011 NY Slip Op 50621(U)) Appellate Term, Second Department, April 6, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted summary judgment on the IME no-show defense after finding, among its elements, that the denial of claim forms were timely mailed.
Tri-Mount Acupuncture, P.C. v N.Y. Cent. Mut. Fire Ins. Co. (2011 NY Slip Op 50335(U)) Appellate Term, Second Department, March 2, 2011Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Granted the insurer summary judgment on its IME no-show defense after finding, among its elements, that the denials based on the nonappearance were timely mailed.
St. Vincent Med. Care, P.C. v Clarendon Natl. Ins. Co. (2010 NY Slip Op 51728(U)) Appellate Term, Second Department, October 1, 2010Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer established timely mailing of its denial forms, including those denying claims on the IME no-show ground, before granting it judgment on that defense.
Points of Health Acupuncture, P.C. v Lancer Ins. Co. (2010 NY Slip Op 51455(U)) Appellate Term, Second Department, August 12, 2010Timely denial required as part of the no-show defense, and the insurer showed itRejected the lower court's finding that the denials were not shown timely mailed, holding the no-fault specialist's affidavit established timely mailing of the denials on the EUO no-show ground.
Points of Health Acupuncture, P.C. v Lancer Ins. Co. (2010 NY Slip Op 51338(U)) Appellate Term, Second Department, July 22, 2010No-show defense is subject to preclusion and fails for want of a timely, proper denialTreated the EUO no-show defense as subject to the 30-day rule: it succeeded on claims with proved timely denials, but for the remaining claims delay letters and unproved verification requests did not toll, so defenses were precluded.
Infinity Health Prods., Ltd. v Progressive Ins. Co. (2010 NY Slip Op 51334(U)) Appellate Term, Second Department, July 22, 2010No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show its denials were timely, and thus that it was not precluded from asserting the EUO no-show defense, because unproved mailing of the scheduling letters meant the 30-day period was not shown tolled.
Five Boro Psychological Servs., P.C. v Progressive Northeastern Ins. Co. (2010 NY Slip Op 50991(U)) Appellate Term, Second Department, June 4, 2010Timely denial required as part of the no-show defense, and the insurer showed itHeld the insurer was required to show, and did show, that it timely and properly denied the claims on the EUO no-show ground, rejecting the challenge to proof of the denials' mailing date.
Central Radiology Servs., P.C. v MVAIC (2010 NY Slip Op 50887(U)) Appellate Term, Second Department, May 13, 2010No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its IME no-show defense because the scheduler's letters, addressed to the insurer with only a copy to the assignor, were not proper verification requests and did not toll the time to pay or deny.
St. Vincent Med. Care, P.C. v Travelers Ins. Co. (2010 NY Slip Op 50446(U)) Appellate Term, Second Department, March 10, 2010No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer failed to show it tolled its time to pay or deny, so its EUO no-show denial raised no triable issue, because the scheduling letters went out 52 days after receipt of the bills.
Bath Med. Supply, Inc. v Allstate Indem. Co. (2010 NY Slip Op 20059) Appellate Term, Second Department, February 19, 2010No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer had not established that its EUO no-show defense was not precluded because it failed to show that it timely denied the provider's claims.
Advanced Med., P.C. v Utica Mut. Ins. Co. (2009 NY Slip Op 51023(U)) Appellate Term, Second Department, May 22, 2009No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer precluded from asserting the EUO no-show defense because, without proof the scheduling letters were timely mailed, the 30 days were not tolled and the denials were not shown to be timely.
A.B. Med. Servs., PLLC v Country-Wide Ins. Co. (2009 NY Slip Op 50583(U)) Appellate Term, Second Department, April 1, 2009No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held that, because the IME scheduling letters were not proved mailed, the insurer failed to timely deny the claims and was precluded from asserting its defenses, including the IME no-show.
Great Wall Acupuncture, P.C. v New York Central Mutual Insurance Company (2009 NY Slip Op 50224(U)) Appellate Term, Second Department, February 10, 2009No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from relying on the EUO no-show because it did not timely request the EUO after receiving the bills, so its time to pay or deny was not tolled.
Wei Wei Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2007 NY Slip Op 50394(U)) Appellate Term, Second Department, March 5, 2007No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer precluded from most defenses, including the EUO no-show, because without proof the EUO requests were mailed the 30-day period to deny was not shown to be tolled.
Great Wall Acupuncture v Utica Mut. Ins. Co. (2007 NY Slip Op 50389(U)) Appellate Term, Second Department, March 2, 2007No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Applied the preclusion rule to the IME no-show defense, holding that without proof the IME requests were mailed the 30-day period was not tolled, so the insurer was precluded from most defenses.
Vitality Chiropractic, P.C. v Kemper Ins. Co. (2006 NY Slip Op 26536) Appellate Term, Second Department, December 11, 2006No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the IME no-show denial of one claim untimely because pre-claim IME requests did not toll, and a delay letter without follow-up requests did not extend the 30 days; other claims were timely denied on that ground.
AVA Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 52256(U)) Appellate Term, Second Department, November 15, 2006No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's claim that it timely denied on the IME no-show ground, holding that unproven mailing of the IME requests meant the 30-day period was not tolled, so the denials were untimely and defenses precluded.
Colonia Med., P.C. v Travelers Ins. Co. (2006 NY Slip Op 51186(U)) Appellate Term, Second Department, June 8, 2006No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its IME no-show defense because it did not show its denial was timely, having failed to prove that verification requests tolling the 30-day period were mailed.
Amaze Med. Supply Inc. v Allstate Ins. Co. (2006 NY Slip Op 50909(U)) Appellate Term, Second Department, May 17, 2006Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's opposition sufficient where it showed timely mailing of its denial on the pre-claim IME no-show ground along with the IME requests and the nonappearance.
Rigid Med. of Flatbush, P.C. v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 50582(U)) Appellate Term, Second Department, April 6, 2006No-show defense is subject to preclusion and fails for want of a timely, proper denialRejected the insurer's claim of a timely EUO no-show denial, holding that EUO requests unauthorized by the policy and unproven as mailed could not toll the 30 days, so the late denial precluded its defenses.
Star Med. Servs. P.C. v Utica Mut. Ins. Co. (2006 NY Slip Op 50505(U)) Appellate Term, Second Department, March 27, 2006No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show defense precluded because, without proof that the policy authorized EUOs, the EUO requests did not toll the 30-day period and the denial was untimely.
A.B. Med. Servs. PLLC v Prudential Prop. & Cas. Ins. Co. (2006 NY Slip Op 50504(U)) Appellate Term, Second Department, March 27, 2006No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the EUO no-show defense unavailable on the untimely-denied claims because, with no proof the EUO request was mailed, the request did not toll the 30-day period, so the denials were untimely and preclusion applied.
A.B. Med. Servs. PLLC v Liberty Mut. Ins. Co. (2005 NY Slip Op 51902(U)) Appellate Term, Second Department, November 21, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the IME no-show defense unavailable on one claim because no denial was in the record and, even if the proffered denial covered it, the form was fatally defective for omitting required information.
Ocean Diagnostic Imaging, P.C. v Utica Mut. Ins. Co. (2005 NY Slip Op 51747(U)) Appellate Term, Second Department, October 21, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its EUO no-show defense because its untimely initial EUO request did not toll the 30 days and the denial issued six months after receipt of the claim.
A.B. Med. Servs. PLLC v Utica Mut. Ins. Co. (2005 NY Slip Op 25456) Appellate Term, Second Department, October 21, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the IME no-show defense unavailable for most claims because the insurer's letters did not toll and no follow-up IME was requested, so its denial was untimely and defective and the claims payable.
A.B. Med. Servs. PLLC v USAA Gen. Indem. Co. (2005 NY Slip Op 25297) Appellate Term, Second Department, July 21, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer precluded from asserting the IME nonattendance defense on claims it never timely denied or tolled by a verification request.
Ocean Diagnostic Imaging P.C. v New York Cent. Mut. Fire Ins. Co. (2005 NY Slip Op 51772(U)) Appellate Term, Second Department, July 7, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its IME nonattendance defense for one assignor's claim because the denial was untimely: the verification and post-claim IME requests were not proved mailed and lacked the required follow-up.
Summit Psychological, P.C. v General Assur. Co. (2005 NY Slip Op 25263) Appellate Term, Second Department, June 28, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from asserting nonattendance at pre-claim IMEs because its proof did not establish that the denial forms were mailed within 30 days after receipt of the claims.
D.A.V. Chiropractic P.C. v American Tr. Ins. Co. (2005 NYSlipOp 50609(U)) Appellate Term, Second Department, April 22, 2005Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that a pre-claim IME no-show defense must be timely asserted in the denial and noted it was undisputed that the insurer timely denied on that ground.
Careplus Med. Supply Inc. v General Assur. Co. (2005 NY Slip Op 50429(U)) Appellate Term, Second Department, March 31, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from asserting the IME nonattendance defense to one claim because the record showed that claim was untimely denied; the other claims were timely denied.
Ocean Diagnostic Imaging P.C. v State Farm Mut. Auto. Ins. Co. (2005 NY Slip Op 25336) Appellate Term, Second Department, March 1, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the EUO request did not toll the 30-day period because the pre-April 2002 regulations gave no right to an EUO, so the denial was untimely and the no-show opposition was without merit.
Triboro Chiropractic v New York Cent. Mut. Fire Ins. Co. (2005 NY Slip Op 50110(U)) Appellate Term, Second Department, February 2, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the claims untimely denied payable despite the assignor's IME nonappearance because no defense survived the preclusive effect of the untimely denials.
King's Med. Supply Inc. v New York Cent. Mut. Fire Ins. Co. (2004 NY Slip Op 51550(U)) Appellate Term, Second Department, December 8, 2004No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the IME no-show denials premature and ineffective because no follow-up request was sent, so the time to pay or deny expired and the insurer was precluded, lacking a meritorious defense for vacatur.
S & M Supply Inc. v State Farm Mut. Auto. Ins. Co. (2004 NY Slip Op 51250(U)) Appellate Term, Second Department, October 20, 2004No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer, having conceded it did not pay or deny within 30 days, was precluded from asserting its defense based on the assignors' failures to attend EUOs.
S & M Supply Inc. v State Farm Mut. Auto. Ins. Co. (2004 NY Slip Op 50693(U)) Appellate Term, Second Department, June 30, 2004No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from asserting the EUO no-show defense because its untimely EUO requests did not toll the 30-day period, so its denials issued months after receipt of the claims were untimely.
S & M Supply, Inc. v Nationwide Mut. Ins. Co. (2004 NY Slip Op 50557(U)) Appellate Term, Second Department, June 3, 2004No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld that because the regulation then in effect did not provide for EUOs, the EUO requests did not toll the 30 days, so the no-show denial was untimely and the provider was granted summary judgment.
A.B. Med. Servs. PLLC Royalton Chiropractic P.C. v Lumbermens Mut. Cas. Co. (2003 NY Slip Op 51393(U)) Appellate Term, Second Department, October 21, 2003No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld bills denied for an EUO no-show payable because, under the 2001 regulation that required no EUOs, the EUO request did not toll the 30-day period and the denial was untimely.

Trial courts in the First Department (10 decisions)

Kim v State Farm Ins. Co. (2024 NY Slip Op 51364(U)) Civil Court of the City of New York, New York County, June 10, 2024Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that an EUO no-show defense requires a timely denial and found the insurer established timely and proper mailing of its denial of claim forms, though the motion failed on another ground.
State Farm Fire & Cas. Co. v Blackburn (2023 NY Slip Op 50745(U)) Supreme Court, New York County, July 13, 2023No-show voids coverage; insurer need not show a timely denial (also decides)Rejected the providers' argument that the insurer failed to show timely mailing of its denials, holding an EUO no-show breaches a condition precedent to coverage regardless of whether denials were timely.
Park Ave. Chiropractic & Health Care PC v Maya Assur. Co. (2021 NY Slip Op 50804(U)) Civil Court of the City of New York, Bronx County, August 18, 2021No-show voids coverage; insurer need not show a timely denial (also decides)Held the EUO no-show breached a condition precedent to coverage, letting the insurer deny all claims retroactively regardless of the timeliness of its denials, so medical necessity was not reached.
Alsaad Med., P.C. v State Farm Mut. Auto. Ins. Co. (2021 NY Slip Op50532(U)) Civil Court of the City of New York, Bronx County, June 8, 2021No-show voids coverage; insurer need not show a timely denialHeld the EUO no-show defense survived although the denial was untimely, because failure to appear breaches a condition precedent to coverage, voids the policy ab initio and cannot be precluded.
Tian Shan Acupuncture PC v Global Liberty Ins. Co. (2019 NY Slip Op 50728(U)) Civil Court of the City of New York, Bronx County, May 14, 2019No-show voids coverage; insurer need not show a timely denial (also decides)Applied the rule that an IME no-show breaches a condition precedent to coverage, allowing denial of all claims regardless of whether prior denials were timely, though it also found the no-show denial timely.
Matter of Global Liberty Ins. Co. v Professional Chiropractic Care P.C. (2015 NY Slip Op 50936(U)) Supreme Court, Bronx County, June 22, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denialUpheld as rational a master arbitrator's award for the provider resting on a denial that misstated the missed IME/EUO date and so lacked specificity, rejecting the argument that the no-show coverage rule compelled dismissal as a mere error of law.
New Capital Supply, Inc. v State Farm Mut. Auto. Ins. Co. (2014 NY Slip Op 24277) Civil Court of the City of New York, New York County, August 14, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer proved it timely and properly mailed the denial along with the EUO letters and the provider's nonappearance, and granted summary judgment.
Medcare Supply Inc. v Travelers Prop. Cas. Co. of Am. (2014 NY Slip Op 51421(U)) Civil Court of the City of New York, New York County, August 13, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found that the insurer proved timely and proper mailing of its NF-10 denials as part of its EUO no-show defense, though the defense failed on other proof.

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Repwest Ins. Co. v Advantage Radiology, P.C. (2014 NY Slip Op 50016(U)) Supreme Court, New York County, January 13, 2014No-show voids coverage; insurer need not show a timely denial (also decides)Applied the rule that an EUO no-show breaches a condition precedent to coverage, letting the insurer deny all claims retroactively regardless of whether the denials were timely issued.
American Tr. Ins. Co. v Miranda (2013 NY Slip Op 52277(U)) Supreme Court, New York County, December 12, 2013No-show voids coverage; insurer need not show a timely denialRejected the defendants' late-disclaimer argument, holding that in the First Department an IME no-show voids the policy so the defense survives even a denial issued after the 30-day period.

Trial courts in the Second Department (46 decisions)

Clinton Med. Off. P.C. v Progressive Max Ins. Co. (2026 NY Slip Op 26094) Civil Court of the City of New York, Richmond County, June 22, 2026Timely denial required as part of the no-show defense, and the insurer showed itHeld the EUO no-show denials sufficient and the defense not defeated, because denials need not list the missed EUO dates; it confined the contrary First Department rule to a misleading partial denial.
Palms P.T., P.C. v State Farm Fire & Cas. Co. (2025 NY Slip Op 50706(U)) Civil Court of the City of New York, Kings County, May 2, 2025Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Treated the EUOs scheduled during the pandemic closure as nullities, counted the June and July 2020 dates as the two no-shows, and found the insurer's denial timely.
Precision Acupuncture P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50021(U)) Civil Court of the City of New York, Kings County, January 14, 2025Timely denial required as part of the no-show defense, and the insurer showed itHeld a bill received between the two EUO no-shows stayed tolled under the pending EUO request, so its denial within 30 days of the second no-show was timely.
MLG Med. P.C. v Nationwide Mut. Ins. Co. (2023 NY Slip Op 23199) Civil Court of the City of New York, Queens County, June 30, 2023Timely denial required as part of the no-show defense, and the insurer showed itHeld the denial issued after the fourth and last missed EUO was timely, rejecting the argument that the 30 days ran from the second nonappearance, in light of the appellate reversal permitting denial after the last scheduled EUO.
Sloan v Nationwide Mut. Ins. Co. (2022 NY Slip Op 50997(U)) Civil Court of the City of New York, Queens County, October 13, 2022No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show denial untimely because the initial EUO request came too late to toll, and in any event the 30 days ran from the second nonappearance, so the denial months later was late.
Fine Needle Acupuncture P.C. v State Farm Mut. Auto. Ins. Co. (2022 NY Slip Op 50873(U)) Civil Court of the City of New York, Queens County, September 16, 2022Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Required, in addition to the estopped nonappearance issue, that the insurer show it timely denied the claim on the EUO no-show ground, and found it did.
Life Equip., Inc v Mid-Century Ins Co (2022 NY Slip Op 50877(U)) Civil Court of the City of New York, Kings County, August 9, 2022Timely denial required as part of the no-show defense, and the insurer showed itTreated a timely denial on the no-show ground as an element of the insurer's defense and found it established because the mailing manager's affidavit and certificates of mailing proved the denials went out within 30 days.
FJL Med. Servs. PC v Nationwide Ins. (2021 NY Slip Op 21214) Civil Court of the City of New York, Kings County, July 28, 2021Timely denial required as part of the no-show defense, and the insurer showed itHeld the denial issued a week after the fourth missed EUO was timely, because the insurer had rescheduled at the provider's own request, so a denial more than 30 days after the second no-show was not untimely.

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MSB Physical Therapy, P.C. v Nationwide Ins. (2021 NY Slip Op 50750(U)) Civil Court of the City of New York, Kings County, July 13, 2021No-show defense is subject to preclusion and fails for want of a timely, proper denialTreated the EUO no-show defense as subject to the 30-day rule: denials of five bills were untimely because the toll ended at the second post-receipt nonappearance or pre-claim letters did not toll, while three bills were timely denied.
New York Core Chiropractic, P.C. v Ameriprise Ins. Co. (2021 NY Slip Op 50599(U)) Civil Court of the City of New York, Queens County, June 24, 2021Timely denial required as part of the no-show defense, and the insurer showed itHeld the denial timely because the two-day-late initial EUO request only cut the insurer's time to 28 days, and the denial issued seven days after the third nonappearance, so the no-show defense was not precluded.
Advanced Recovery v Allstate Ins. Co. (2021 NY Slip Op 21148) Civil Court of the City of New York, Queens County, May 27, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)After reciting that an insurer failing to timely deny is precluded, held the insurer's mailing affidavits adequately demonstrated timely denial of the claims on the IME no-show ground.
Parisien v Travelers Ins. Co. (2021 NY Slip Op 50396(U)) Civil Court of the City of New York, Kings County, April 30, 2021Timely denial required as part of the no-show defense, and the insurer showed itApplied the rule that the insurer must show a timely denial as an element of its EUO no-show defense, and found the denials issued within 30 days and proved mailed, rejecting the provider's challenges to their mailing and timing.
NY Wellness Med. P.C. v Ameriprise Ins. Co. (2021 NY Slip Op 50382(U)) Civil Court of the City of New York, Queens County, April 29, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer's EUO no-show denials timely: bills received before the second nonappearance were tolled by delay letters naming the provider and denied within 30 days after the last missed EUO, and later bills were denied on that ground.
Kings County Physicians Group v Nationwide Ins. Co. (2021 NY Slip Op 50337(U)) Civil Court of the City of New York, Queens County, April 16, 2021Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that an untimely denial precludes the defense and found the insurer's mailing affidavits showed it denied the claims within 30 days after the last EUO nonappearance, so the denials were timely.
Sayyed DC, P.C. v Ameriprise Ins. Co. (2021 NY Slip Op 50311(U)) Civil Court of the City of New York, Queens County, April 13, 2021No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show denial of two bills untimely because explanation-of-benefits letters delaying payment pending an EUO did not request verification and so did not toll the 30 days, entitling the provider to judgment on them.
Longevity Med. Supply, Inc. v Progressive Ins. Co. (2020 NY Slip Op 20137) Civil Court of the City of New York, Kings County, June 17, 2020Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Required the insurer to show a timely denial on the IME no-show ground as an element of its defense and found the denials timely mailed, though the defense failed on mailing and nonappearance proof.
New Chiropractic Care, P.C. v Nationwide Ins. Co. of N.Y. (2020 NY Slip Op 50652(U)) Civil Court of the City of New York, Kings County, June 1, 2020No-show defense is subject to preclusion and fails for want of a timely, proper denialApplied the 30-day rule to the EUO no-show defense: for one bill the first EUO letter was mailed over 30 days after receipt, so nothing tolled and the late denial defeated the defense; other bills' denials were timely.
Krasner Chiropractic, P.C. v IDS Prop. & Cas. Ins. Co. (2019 NY Slip Op 29382) Civil Court of the City of New York, Richmond County, November 12, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the provider EUO no-show defense precluded because the insurer, bound by its earlier denials on other grounds, could not later reopen the denied claims and demand an EUO, making the requests untimely.
Sama Physical Therapy v MVAIC (2019 NY Slip Op 29218) Civil Court of the City of New York, Queens County, July 15, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld that MVAIC's EUO-based defense that the assignor was not a qualified person rested on a breach of a policy condition subject to preclusion, not a coverage defense; because the EUO requests came two years after the bills, MVAIC failed to timely deny and was precluded.
Island Life Chiropractic Pain Care PLLC v Amica Mut. Ins. Co. (2019 NY Slip Op 51589(U)) Civil Court of the City of New York, Kings County, May 17, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the insurer had to show a timely denial for its EUO no-show defense and failed to, because the verification request it relied on to extend its time was not in the record.
Prompt Med. Supply, Inc. v Metropolitan Group Prop. & Cas. Ins (2019 NY Slip Op 51594(U)) Civil Court of the City of New York, Kings County, March 28, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Required a timely denial as an element of the EUO no-show defense and held it not established because the adjuster did not show the denials were correctly addressed and properly stamped.
Pavlova v Allstate Ins. Co. (2019 NY Slip Op 50016(U)) Civil Court of the City of New York, Kings County, January 2, 2019No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show defense precluded because the denials were issued about two months after the last scheduled EUO, beyond the 30 days the insurer had to pay or deny after that date.
Neuro Rehab Med. Servs. of S.I., P.C. v State Farm Mut. Auto. Ins. Co. (2018 NY Slip Op 50671(U)) District Court of Suffolk County, Third District, May 4, 2018Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the denials were not mailed within 30 days of the last EUO, finding the denial forms timely mailed within the pay-or-deny period.
Central Park Physical Medicine & Rehab., P.C. v Travelers Indem. Co. of Conn. (2017 NY Slip Op 51354(U)) District Court of Suffolk County, Fourth District, June 27, 2017Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's claim that the denials were not mailed within 30 days of the last EUO, holding that the insurer had 30 days from the second no-show and timely mailed its denials within 14 days.
Z.M.S. & Y. Acupuncture, P.C. v Geico Gen. Ins. Co. (2017 NY Slip Op 27189) Civil Court of the City of New York, Kings County, May 26, 2017Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Rejected the provider's argument that the denials were untimely because of a late follow-up EUO letter, finding the one-day delay excused under 65-3.5 (p) and the denials timely and properly mailed.
Sure Way NY, Inc. v Travelers Ins. Co. (2016 NY Slip Op 26413) Civil Court of the City of New York, Kings County, December 8, 2016Timely denial required as part of the no-show defense, and the insurer showed itHeld the denial timely because, with the provider EUO request made within 15 business days of the assignor's EUO, no days were deducted and the denial issued two days after the second no-show.
Golden Needle Acupuncture P.C. v MAPFRE Ins. Co. (2016 NY Slip Op 26411) Civil Court of the City of New York, Kings County, November 30, 2016No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show defense precluded for two claims because it is a precludable defense, the denials came months after receipt, and the EUO requests, sent more than 30 days after receipt, did not toll the time.
NY Rehab Pain Mgt. & Med. Servs., PC v State Farm Auto Ins. Co. (2016 NY Slip Op 50821(U)) Supreme Court, Nassau County, May 24, 2016Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that the insurer must show two demanded EUOs, two nonappearances and a timely denial, and granted it judgment after accepting its proof that the no-show denials were generated and mailed.
Alleviation Med. Servs., PC v Hertz Co. (2015 NY Slip Op 25285) Civil Court of the City of New York, Kings County, August 12, 2015No-show defense is subject to preclusion and fails for want of a timely, proper denial (also decides)Held the IME no-show denial untimely because it issued more than 30 days after the last missed IME, so it did not defeat the provider's claim.
Prestige Med. P.C. v Travelers Home & Mar. Ins. Co. (2014 NY Slip Op 24317) Civil Court of the City of New York, Kings County, October 5, 2014Timely denial required as part of the no-show defense, and the insurer showed itHeld that an insurer requesting a provider EUO outside the 15-business-day period forfeited the right to deny late on the no-show, but the denial was timely within the reduced 26-day period.
Rutland Med., P.C. v State Farm Ins. Co. (2014 NY Slip Op 24298) Civil Court of the City of New York, Kings County, October 1, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer established that the claims were timely denied, together with mailing of the EUO letters and nonappearance, though the defense went to trial on the excuse issue.
Hempstead Regional Chiropractic, PC v Allstate Ins. Co. (2014 NY Slip Op 24259) District Court of Nassau County, First District, September 8, 2014Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Applied the rule that an insurer may deny all claims after an EUO no-show only by a timely denial on that ground, and found the claims timely denied.
Natural Therapy Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2013 NYSlip Op 51935(U)) Civil Court of the City of New York, Kings County, November 21, 2013No-show voids coverage; insurer need not show a timely denial (also decides)Held the provider's failure to appear for duly scheduled EUOs breached a condition precedent that voided the policy ab initio, so the insurer owed nothing regardless of whether its denials were issued within 30 days.
LK Health Care Prods. Inc v GEICO Gen. Ins. Co. (2013 NY Slip Op 50810(U)) Civil Court of the City of New York, Kings County, May 9, 2013No-show voids coverage; insurer need not show a timely denial (also decides)Held the provider's EUO no-show breached a condition precedent and voided the policy ab initio, so the insurer owed nothing regardless of whether its denials were issued beyond 30 days.
Quality Psychological Servs., P.C. v Hartford Ins. Co. (2013 NY Slip Op 50045(U)) Civil Court of the City of New York, Kings County, January 15, 2013Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Found the insurer issued a timely denial within 30 days after the second EUO nonappearance and proved its mailing, so the no-show defense was supported by a proper denial.
GBI Acupuncture, P.C. v Esurance Ins. Co. (2012 NY Slip Op 52423(U)) Civil Court of the City of New York, Kings County, December 26, 2012Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Rejected the provider's claim that the bills were not timely denied, finding the EUO requests and the responsive denials timely and the insurer's mailing procedures for the denials sufficient.
Neomy Med., P.C. v American Tr. Ins. Co. (2011 NY Slip Op 50536(U)) Civil Court of the City of New York, Kings County, April 7, 2011No-show voids coverage; insurer need not show a timely denialHeld that failure to appear for a post-claim IME breaches a condition precedent that voids coverage ab initio, so the defense is not precluded by denials issued beyond 30 days and all claims may be denied retroactively.
Chiropractic Back Care of Queens Vil., P.C. v ELRAC, Inc. (2011 NY Slip Op 50544(U)) District Court of Nassau County, First District, April 1, 2011No-show voids coverage; insurer need not show a timely denial (also decides)Accepted that the insurer need not pay or deny because IME attendance is a condition precedent to liability that is never waived and may be raised at any time, dismissing on the no-show without any denial analysis.
Prime Psychological Servs., PC v ELRAC, Inc. (2009 NY Slip Op 52579(U)) Civil Court of the City of New York, Richmond County, December 4, 2009Timely denial required as part of the no-show defense, and the insurer showed it (also decides)Held the insurer could deny retroactively for the pre-claim IME no-show as long as it mailed the denial within 30 days of receiving the claim, which it did.
Prime Psychological Servs., P.C. v Nationwide Prop. & Cas. Ins. Co. (2009 NY Slip Op 29100) Civil Court of the City of New York, Richmond County, March 5, 2009Timely denial required as part of the no-show defense, and the insurer showed itRejected the provider's argument that the denial was untimely, holding that once the claim was received the insurer had to pay or deny within 30 days and that it established a timely denial based on the pre-claim EUO no-shows.
Five Boro Psychological Servs., P.C. v AutoOne Ins. Co. (2008 NY Slip Op28510) Civil Court of the City of New York, Kings County, December 8, 2008No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from its IME no-show defense because its IME requests were not timely, so they did not toll the 30-day period and the denials were untimely.
A.B. Med. Servs. PLLC v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 26131) Civil Court of the City of New York, Kings County, March 7, 2006No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the insurer precluded from asserting the IME no-show defense because denials were untimely without proof of timely IME requests tolling the 30 days, and the timely denial was ineffective absent a follow-up request.
Boai Zhong Yi Acupuncture Servs. PC v General Assur. Ins Co. (2005 NY Slip Op 50329(U)) Civil Court of the City of New York, Kings County, February 9, 2005No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld IME no-show denials of two claims untimely because scheduling IMEs after verification was received did not extend the 30 days, and an unproved pend letter never tolled the time.
Star Med. Servs., P.C. v Allstate Ins. Co. (2004 NY Slip Op 51280(U)) Civil Court of the City of New York, Kings County, October 27, 2004No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO no-show denial untimely because the insurer never scheduled a second EUO after the first nonappearance, so the 30-day period was not tolled and the provider was entitled to summary judgment.
Star Med. Servs., P.C. v Allstate Ins. Co. (2004 NY Slip Op 24410) Civil Court, Kings County, October 25, 2004No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the EUO requests sent to the driver's wrong address and to his personal-injury attorney were not valid requests, so the 30 days were not tolled and the no-show denial was untimely.
Ocean Diagnostic Imaging v Utica Mut. Ins. Co. (2004 NY Slip Op 50203(U)) District Court of Nassau County, Third District, March 29, 2004No-show defense is subject to preclusion and fails for want of a timely, proper denialHeld the IME no-show denial untimely and the defense precluded because the first IME was scheduled more than 30 days after the claim and no timely verification requests tolled the 30-day period.

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