November 24, 2020

Unitrin Direct Ins. Co. v Beckles (2020 NY Slip Op 06974)

Headnote

The court considered the fact that the insurance company, Unitrin Direct Insurance Company, had submitted evidence of a medical provider claim (NF-3), and had timely requested an independent medical examination (IME) of the injured claimant within 15 days of the receipt of that claim. The injured claimant had failed to appear at two scheduled IMEs. The main issue was whether the insurer was entitled to disclaim coverage for no-fault benefits for the injured claimant. The court held that the basis for disclaimer of coverage was established as a matter of law, and granted summary judgment to the insurer, declaring that the insurer had no coverage obligation for the no-fault benefits sought by the defendants-respondents. The court also directed the clerk to enter judgment accordingly.

Reported in New York Official Reports at Unitrin Direct Ins. Co. v Beckles (2020 NY Slip Op 06974)

Unitrin Direct Ins. Co. v Beckles

2020 NY Slip Op 06974 [188 AD3d 620]

November 24, 2020

Appellate Division, First Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

As corrected through Wednesday, December 30, 2020

[*1]

Unitrin Direct Insurance Company, Appellant,
v
Alan Dennis Beckles, M.D., et al., Defendants, and Jules Francois Parisien, M.D., et al., Respondents.

Goldberg, Miller & Rubin P.C., New York (Eli Shmulik and Harlan R. Schreiber of counsel), for appellant.

The Rybak Firm PLLC, Brooklyn (Maksim Leyvi of counsel), for respondents.

Order, Supreme Court, New York County (Melissa A. Crane, J.), entered on or about November 1, 2019, which denied summary judgment on plaintiff’s first cause of action for a declaration disclaiming coverage for no-fault benefits sought by defendants-respondents Jules Francois Parisien, M.D. and SP Orthotic Surgical & Medical Supply, Inc., unanimously reversed, on the law, with costs, the motion granted, and it is declared that plaintiff has no coverage obligation for no-fault benefits sought by the defendants-respondents. The Clerk is directed to enter judgment accordingly.

Where, as here, the insurer submits evidence of a medical provider claim (NF-3), the timely request for an independent medical examination (IME) of the injured claimant within 15 days of the receipt of that claim, and the injured claimant is a no-show at two duly noticed IMEs, the basis for disclaimer of coverage is established, as a matter of law, and summary judgment is properly awarded to the insurer with respect to further coverage obligations and reimbursement of outstanding medical bills with respect to all treating providers (see Kemper Independence Ins. Co. v Adelaida Physical Therapy, P.C., 147 AD3d 437 [1st Dept 2017]; National Liab. & Fire Ins. Co. v Tam Med. Supply Corp., 131 AD3d 851 [1st Dept 2015]). Concur—Renwick, J.P., Kapnick, Gesmer, Kern, JJ.