Key Takeaway
Court finds EUO no-shows invalid due to unclear circumstances and potential rescheduling, with Civil Court judges granting plaintiff summary judgment in multiple cases.
(1) “Here, defendant alleges that plaintiff’s assignor was scheduled to appear for an EUO on four different dates, that he did not appear at all, and that his conduct constituted a failure to comply with a condition precedent to coverage. However, defendant concedes on appeal that the second and third examination dates had been mutually rescheduled prior to the appointed time, and therefore a no-show on those dates would not be deemed to constitute a failure to appear”
(2) “Furthermore, it is unclear from the record whether the first EUO had been mutually rescheduled prior to the appointed time, in which case it would not constitute a failure to appear. Even if it had not been, the circumstances surrounding the first and fourth scheduled examination dates are so unclear on this record that it is impossible to tell whether there might potentially be another basis to find that either date should not be deemed to constitute a failure to appear.”
I am curious what the other basis is.
Also, in three cases, three different Civil Court judges granted Plaintiff summary judgment. Did you notice this?
St. Chiropractic, P.C. v Ameriprise Auto & Home
Avicenna Med. Arts, P.L.L.C. v Ameriprise Auto & Home
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