In Massachusetts, the Boston Municipal Court's Appellate Division decided the case of Cotton v. Hanover Insurance Company (Lawyers Weekly No. 13-010-1), in favor of the insurance company because the claimant failed to show up to two scheduled medical examination appointments.
In the Cotton case, the judge denied "personal injury benefits" to the injured person because he failed to attend two scheduled independent medical examinations. These are also known as "insurance medical examinations." The injured person tried to argue that an insurance company must show actual prejudice before it can deny an injured person's claim for benefits even if an injured person fails to attend two medical examination appointments. But the Court disagreed.
It was held that the trial judge acted permissibly in finding for the insurance company without requiring the defendant insurance company to show that it had been prejudiced by the plaintiff's conduct, or by the injured person's failure to attend the medical examination appointments.
By way of legal ease, this is what the Court held: '[A]n insurer must demonstrate prejudice when denying PIP benefits because of the late filing of the application. ...' And Boffoli stated flatly that '[a]s a general rule, breach of an insured's duty to cooperate does not permit an insurer to disclaim coverage absent a showing of prejudice.' ... The only stated exception to that prejudice requirement would be an insured's willful and unexcused refusal to comply with an insurer's timely request for an examination under oath. ..." In Cotton, the Court extended the rule governing examinations under oath to insurance medical examinations. Therefore, you must attend medical examinations, and the best way to navigate the myriad insurance rules and requirements like medical examinations, is to speak with a qualified and experienced attorney to assist you.
The Boston car accident attorneys at the Law Office of Neil Burns can help you navigate Massachusetts laws and rules regarding car accidents and insurance, which are numerous and can be complicated. If you have been injured in a car accident, contact us today.
