EUO Declaratory Judgment

Nationwide Affinity Ins. Co. of Am. v George, 2020 NY Slip Op 02801 (2d Dept. 2020)

I think you have to read the docket here to understand what happened. It appears the mailing issues involved completion or lack of completion of apartment numbers. The record appears to show that various documents were with and without apartment numbers. The court thus was not going to disturb Supreme Court’s findings on the issues. The proof of no-show was based upon bust statements.

What was interesting is the mutual rescheduling issue. I could not find anything in the record supporting a mutual rescheduling of the first EUO. The Second EUO issue is interested. Defendant presented a bust statement where attorney Diamond was present and never mentioned his client’s were running late. Then, after this litigation was commended, Diamond presented an affirmation that his clients were running late.

The Court properly found an issue of fact was not raised. Had the carrier relief on affidavits (as opposed to bust statements), I think the outcome would differ. This has to be the first time I can state bust statements really made the difference.

Finally, the Court granted judgment despite four bills not being paid or denied – the basis for the disclaimer (besides EUO no show) that the bills were untimely submitted.

I suspect the Court did not like the provider’s hype-technical arguments that, on balance, had minimal record support and opened the Unitrin door, whether inadvertantly or otherwise. Tough loss for the provider, but these things do happen

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