Opinion
2019-1427 K C
02-19-2021
CITY ANESTHESIA HEALTHCARE, P.C., as Assignee of Edward Ortiz, Respondent, v. ERIE INSURANCE CO. OF NY, Appellant.
Robyn M. Brilliant, P.C. ( Robyn M. Brilliant and Barry Montrose of counsel), for appellant. Zara Javakov, P.C. (Zara Javakov and Victoria Tarasova of counsel), for respondent.
Robyn M. Brilliant, P.C. ( Robyn M. Brilliant and Barry Montrose of counsel), for appellant.
Zara Javakov, P.C. (Zara Javakov and Victoria Tarasova of counsel), for respondent.
PRESENT: THOMAS P. ALIOTTA, P.J., MICHELLE WESTON, DAVID ELLIOT, JJ.
ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant's motion for summary judgment dismissing the complaint is granted.
In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from so much of an order of the Civil Court entered March 8, 2019 as denied defendant's motion for summary judgment dismissing the complaint.
Contrary to the determination of the Civil Court, defendant demonstrated that, before it had received the claim at issue, it properly scheduled independent medical examinations (IMEs) of plaintiff's assignor, and that the assignor failed to appear for the duly scheduled IMEs ( see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co. , 35 AD3d 720 [2006] ). Defendant also demonstrated that it timely denied the claim ( see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co. , 50 AD3d 1123 [2008] ), based upon the assignor's failure to appear for the IMEs. An assignor's appearance at an IME "is a condition precedent to the insurer's liability on the policy" ( Stephen Fogel Psychological, P.C. , 35 AD3d at 722 ). Plaintiff's contention that the pre-claim IME scheduling letter was required to be mailed within 30 days of defendant's receipt of the NF-2 lacks merit ( see 11 NYCRR 65-3.5 [a], [d]; Appendix 13).
Accordingly, the order, insofar as appealed from, is reversed, and defendant's motion for summary judgment dismissing the complaint is granted.
ALIOTTA, P.J., WESTON and ELLIOT, JJ., concur.