Integrative Pain Medicine, P.C. v Allstate Ins. Co., 2016 NY Slip Op 51525(U)
“Appearance at an EUO is a condition precedent to coverage (see 11 NYCRR 65—1.1; Interboro Ins. Co. v Clennon, 113 AD3d 596 [2014]; Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]). Upon finding that defendant demonstrated that it had timely and properly denied the claims at issue on the ground that plaintiff’s assignor had failed to appear for duly scheduled EUOs, the Civil Court should not have given plaintiff’s assignor an opportunity to cure its failure to act during claims processing (see IDS Prop. Cas. Ins. Co. v Stracar Med. Services, P.C., 116 AD3d 1005 [2014]). Under the circumstances, the court should have granted defendant’s cross motion for summary judgment unconditionally.”
It is interesting that the Civil Court found that the EIP should have another opportunity to attend EUO, which is what happened in IDS. The Appellate Term, similar to the Appellate Division in IDS, said no more chances and dismissed the complaint. Interesting.
One Response
No easier medical insurance to cancel in the world while benefits are being received than New York State No-Fault insurance.
Does anyone want to argue otherwise?