FILED: BRONX COUNTY CLERK 12/17/ :45 PM

Transcription

1 FILED: BRONX COUNTY CLERK 12/17/ :45 PM INDEX NO /2015E NYSCEF DOC. NO. 8 RECEIVED NYSCEF: 12/17/2015 EXHIBIT F

2 In the Matter of the Claim of YESENIA DIAZ, -against- Claimant, DEMAND FOR EXAMINATION UNDER OATH FIDUCIARY INSURANCE COMPANY OF AMERICA, Respondent. X PLEASE TAKE NOTICE, that pursuant to Section 3102 and Article 75 of the Civil Practice Law and Rules and the terms of the Claimants' insurance policy with FIDUCIARY INSURANCE COMPANY OF AMERICA, the Claimant, YESENIA DIAZ, is hereby required to appear at the offices of SHAYNE, DACHS, SAUER & DACHS, LLP, 114 Old Country Road, Suite 410, Mineola, New York on the 17 th day of February, 2016 at 2:00 o'clock in the afternoon of that day to be orally examined under oath relative to an occurrence that occurred on or about April 9, 2014 and the nature and extent of any personal injuries and/or damages sustained by YESENIA DIAZ for which a certain claim was presented by her. Dated: Mineola, New York December 18, 2015 Yours etc., SHAYNE, DACHS, SAUER & DACHS, LLP JON "'THAN A. IDACHS Attorneys for Respondent 114 Old Country Road, Suite 410 Mineola, New York (516)

3 TO: YADGAROV & ASSOCIATES, PLLC Attorneys for Claimant 608 Fifth Avenue, Suite 1000 New York, New York (212) SUM.1

4 In the Matter of the Claim of YESENIA DIAZ, Claimant, COMBINED DEMANDS -against- FIDUCIARY INSURANCE COMPANY OF AMERICA, Respondent. X S I R S: PLEASE TAKE NOTICE that pursuant to the policy of insurance issued by Respondent and Articles 31 and 75 of the Civil Practice Law and Rules, demand is herewith made as follows: 1. That you serve and deliver a copy of the Claimant's MV-104 reports or other written statements concerning the facts and circumstances of the accident that is the subject of their claim. 2. That you serve and deliver written proof of the claim setting forth full particulars of the nature and extent of the injuries, liability, lost earnings, treatment and other details entering into the determination of the amount claimed under the UM Endorsement. 3. That you serve and deliver to the undersigned copies of medical records of those physicians, hospitals, and medical providers, who have treated or examined the Claimant. These medical reports shall include a detailed recitation of the injuries and conditions for which claim will be made, identifying and referring to those x-ray, technician's reports, and diagnostic tests which are relevant and material to the injuries claimed. 4. That you serve and deliver to the undersigned duly executed and acknowledged authorizations permitting the undersigned to obtain and make copies of all hospital records and such reports and records as may be referred to and be identified in any of the physician's statements and/or be relevant to the claims of injury and damages, including authorizations for all medical providers and diagnostic tests and films, and employment records, for this alleged accident, and any

5 prior accidents in which Claimant has sustained injuries to the same parts of the body injured in this accident, as well as the No-Fault file pertaining to these claims. 5. That you serve and deliver to the undersigned complete bills rendered for medical, hospital and related services for which claim will be made. 6. That each party seeking claim hereunder submit to physical examinations by physicians selected by the undersigned on a date and at a time and place to be specified following service and delivery to the undersigned of medical reports, authorizations and other material aforementioned. PLEASE TAKE FURTHER NOTICE that all proceedings preliminary to the arbitration hearing should be completed prior to the commencement of the arbitration hearing. Dated: Mineola, New York December 18, 2015 Yours etc., TO: YADGAROV & ASSOCIATES, PLLC Attorneys for Claimant 608 Fifth Avenue, Suite 1000 New York, New York (212) SUM.2 SHAYNE, DACHS SAUER & DACHS, LLP w!0 rillt4\1' JO ATHAN A. DACHS Attorneys for Respondent 114 Old Country Road, Suite 410 Mineola, New York (516)