Parisien v Citiwide Auto Leasing, 2019 NY Slip Op 51050(U)(App. Term 2d Dept. 2019)
The IME no-show disclaimer that is delayed for the verification. Many try to take the view that you cannot wait for verification since it will not change how the claim is handled. It is a very good argument and, in a world without preclusion, I think it wins the day.
“Although plaintiff’s assignor failed to appear for the second scheduled EUO more than 45 days before the subject claims were denied, defendant was not precluded from interposing its defense based upon the assignor’s failure to appear for the EUOs, because defendant’s time to pay or deny the claims did not begin to run until it received the requested written verification (see Alev Med. Supply, Inc. v New York Cent. Mut. Fire Ins. Co., 38 Misc 3d 143[A], 2013 NY Slip Op 50258[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2013]). Thus, defendant established its prima facie entitlement to summary judgment, and plaintiff failed to raise a triable issue of fact in opposition. “
2 Responses
A decision without Logic. The court says Plaintiff wait for a denial based on EUO no show even thought the breach OCCURRED months before. Whats the point of complying with the verification requests That the CARRIER wont even attach as there are none and still issues a denial based on EUO no show. Anyway you look at the decision it’s dumb.
Jason and “Rookie” – can you see any reason why the court would reach this decision? I don’t see how the court could have gotten here unless if it is simply following the holding in Alev. However, as Jason points out, this additional verification is not reasonable and would have zero impact on the outcome (unless -if this is even permissible- the verification requested is a written excuse for the no-shows).