Key Takeaway
NY appellate court ruling on EUO no-show requirements: insurers must prove two proper demands, two failures to appear, and timely denial for summary judgment.
Island Life Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co., 2018 NY Slip Op 51552(U)(App. Term 2d Dept. 2018)
“To establish its prima facie entitlement to summary judgment dismissing a complaint on the ground that a provider had failed to appear for an EUO, an insurer must demonstrate, as a matter of law, that it had twice duly demanded an EUO from the provider, that the provider had [*2]twice failed to appear, and that the insurer had issued a timely denial of the claims (see Interboro Ins. Co. v Clennon, 113 AD3d 596, 597 ; Integrative Pain Medicine, P.C. v Praetorian Ins. Co., 53 Misc 3d 140, 2016 NY Slip Op 51520 ). Plaintiff does not challenge that defendant demonstrated its prima facie entitlement to summary judgment, but rather argues that plaintiff raised a triable issue of fact in opposition. However, as plaintiff’s argument lacks merit, the Civil Court should have granted defendant’s motion for summary judgment. We further note that defendant’s transmittal of the claims from one of its offices to another of its offices does not raise a triable issue of fact (see Maiga Prods. Corp. v State Farm Mut. Auto. Ins. Co., 59 Misc 3d 145, 2018 NY Slip Op 50736 ).”
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