Key Takeaway
Second Department court cites Unitrin precedent in no-fault insurance case, reinforcing that willfulness is not required to prove failure to cooperate in EUO matters.
The landscape of New York No-Fault Insurance Law continues to evolve through appellate decisions that shape how insurance companies can enforce examination under oath (EUO) requirements. A recent Second Department case demonstrates the ongoing relevance of the Unitrin precedent, though its application has become more limited over time. This decision addresses two critical aspects of EUO enforcement: the standard for proving failure to cooperate and the procedural requirements for summary judgment motions when claimants fail to appear for scheduled examinations.
The case highlights how courts handle EUO objections and the consequences of non-compliance with properly scheduled examinations. Understanding these nuances is essential for both healthcare providers and insurance companies navigating the no-fault system.
Jason Tenenbaum’s Analysis:
Metro Health Prods., Inc. v State Farm Mut. Auto. Ins. Co., 2015 NY Slip Op 51419(U)(App. Term 2d Dept. 2015)
Do not get too excited; anyway, Unitrin is not what it used to be. The citing here is to a limited proposition of law: ” To the extent plaintiff asserts [*2]that defendant did not demonstrate that plaintiff’s failure to cooperate was willful, defendant complied with the regulations (see 11 NYCRR 65) and there is no requirement to establish willfulness (see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559 ).”
The case also deals with the standard rule that an MSJ for an EUO no-show will not be delayed pending discovery, especially where there has been no objection to the reasonableness of the EUO.
Key Takeaway
This decision reinforces that insurance companies need not prove willfulness when establishing failure to cooperate in EUO matters, provided they comply with regulatory requirements. The court also confirmed that EUO no-show cases can proceed to summary judgment without delay for discovery, particularly when no objections to the examination’s reasonableness were raised.
