O & M Med., P.C. v Travelers Indem. Co., 2015 NY Slip Op 50476(U)(App. Term 2d Dept. 2015)
“Pursuant to the No-Fault Regulations, “any additional verification required by the insurer to establish proof of claim shall be requested within 15 business days of receipt of the [NF-3]” (11 NYCRR 65-3.5 [b] [emphasis added]). This rule applies to requests for EUOs (see e.g. Longevity Medical Supply, Inc. v IDS Property & Cas. Ins. Co., 44 Misc 3d 137[A], 2014 NY Slip Op 51244[U] [App Term, 2d, 11th & 13th Jud Dists 2014]). Here, there was no duly scheduled EUO at which plaintiff failed to appear, since defendant mailed its first EUO scheduling letter nearly three months after having received the claim at issue, rendering the letter a nullity. Consequently, defendant failed to demonstrate that it had properly denied the claim based upon plaintiff’s failure to comply with a condition precedent to coverage”
