Unitrin Advantage Insurance v. Bayshore Physical Therapy, PLLC
Appellate Division of the Supreme Court of the State of New York
1Opinion of the Court
*560The motion court properly determined that plaintiff insurer may retroactively deny claims on the basis of defendants’ assignors’ failure to appear for independent medical examinations (IMEs) requested by plaintiff, even though plaintiff initially denied the claims on the ground of lack of medical necessity (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 721-722 [2006]). The failure to appear for IMEs requested by the insurer “when, and as often as, [it] may reasonably require” (Insurance Department Regulations [11 NYCRR] § 65-1.1) is a breach of a condition…
2Cases cited6 opinions
- Stephen Fogel Psychological, P.C. v. Progressive Casualty InsuranceAppellate Division of the Supreme Court of the State of New York · 2006
- Thrasher v. United States Liability InsuranceNew York Court of Appeals · 1967
- Central General Hospital v. Chubb Group of Insurance CompaniesNew York Court of Appeals · 1997
- A.B. Medical Services PLLC v. USAA General Indemnity Co.Appellate Terms of the Supreme Court of New York · 2005
- Celtic Medical P.C. v. New York Central Mutual Fire InsuranceAppellate Terms of the Supreme Court of New York · 2007
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- Kemper Independence Insurance Co. v. Adelaida Physical Therapy, P.C.Appellate Division of the Supreme Court of the State of New York · 2017
- Unitrin Advantage Ins. Co. v. DowdAppellate Division of the Supreme Court of the State of New York · 2021
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