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Country-Wide Ins. Co. v. Alicea

Supreme Court of New York, First Department
Mar 21, 2023
2023 N.Y. Slip Op. 1474 (N.Y. App. Div. 2023)

Opinion

No. 17532 Index No. 650364/20 Case No. 2022-00879

03-21-2023

Country-Wide Insurance Company, Plaintiff-Respondent, v. Richard Alicea et al., Defendants, SP Orthotic Surgical & Medical Supply, Inc. et al., Defendants-Appellants.

The Rybak Firm, PLLC, Brooklyn (Maksim Leyvi of counsel), for appellants. Thomas Torto, New York, for respondent.


The Rybak Firm, PLLC, Brooklyn (Maksim Leyvi of counsel), for appellants.

Thomas Torto, New York, for respondent.

Before: Kapnick, J.P., Kern, Gesmer, Moulton, Higgitt, JJ.

Order, Supreme Court, New York County (Melissa A. Crane, J.), entered August 27, 2021, which granted plaintiff Country-Wide Insurance Company's motion for summary judgment declaring that plaintiff has no duty to defendants-appellants to pay no-fault claims based on the injured party's failure to appear for examinations under oath (EUO), and permanently stayed any further action involving the injured party, unanimously reversed, on the law, without costs, the motion denied and the declaration and stay vacated.

Although plaintiff timely requested an EUO and subsequently issued a timely denial (see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 A.D.3d 559, 560 [1st Dept 2011]), the motion court erred in granting summary judgment. 11 NYCRR 65-3.5 (e) requires an EUO request be based on application of objective standards, and that the insurer must have a specific objective justification. Summary judgment is premature under CPLR 3212 where an insurer fails to provide a medical provider with its objective justification for requesting the EUO (Country-Wide Ins. Co. v Delacruz, 205 A.D.3d 473, 473 [1st Dept 2022]). This Court has explained that the insurer's reason for the EUO is essential for medical providers to oppose an insurer's summary judgment motion, and that information is in the exclusive knowledge and control of the insurer (American Tr. Ins. Co. v Jaga Med. Servs., P.C., 128 A.D.3d 441, 441 [1st Dept 2015]).

Plaintiff's argument that the opposing defendants waived any objection to the reasonableness of EUO request is unavailing (Country-Wide, 205 A.D.3d at 474).


Summaries of

Country-Wide Ins. Co. v. Alicea

Supreme Court of New York, First Department
Mar 21, 2023
2023 N.Y. Slip Op. 1474 (N.Y. App. Div. 2023)
Case details for

Country-Wide Ins. Co. v. Alicea

Case Details

Full title:Country-Wide Insurance Company, Plaintiff-Respondent, v. Richard Alicea et…

Court:Supreme Court of New York, First Department

Date published: Mar 21, 2023

Citations

2023 N.Y. Slip Op. 1474 (N.Y. App. Div. 2023)