A.C. Med., P.C. v Ameriprise Ins. Co., 2016 NY Slip Op 51787(U) (App. Term 2d Dept. 2016)
“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 prescribed verification forms” (11 NYCRR 65-3.5 [b]). Since defendant received the claim in the amount of $403.58 on August 28, 2012 and mailed an EUO scheduling letter to plaintiff on September 26, 2012, defendant’s time to pay or deny that claim was reduced by the number of days that the EUO request was late (see 11 NYCRR 65-3.8 [l]). However, defendant did not timely deny that claim after plaintiff had failed to appear for the second scheduled EUO (see 11 NYCRR 65-3.8 [a] [1]). With respect to the remaining claims, because defendant did not mail its first EUO scheduling letter to plaintiff within 30 calendar days of receiving those claims, the scheduling letter was rendered a nullity by its untimeliness”
I almost ask myself – are you sometimes better off not showing up for the EUO?
One Response
Only better not showing up if demand is untimely or notice is defective. This is the case even with IME’s, although the claims will be denied upon attendance anyway.