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GLM Med. v. State Farm Mut. Auto. Ins.

Appellate Term of the Supreme Court of New York, Second Department
Feb 14, 2011
2011 N.Y. Slip Op. 50194 (N.Y. App. Term 2011)

Opinion

2009-2180 K C.

Decided February 14, 2011.

Appeal from an order of the Civil Court of the City of New York, Kings County (Robin D. Garson, J.), entered August 20, 2009. The order denied defendant's motion for summary judgment dismissing the complaint.

ORDERED that the order is reversed, without costs, and defendant's motion for summary judgment dismissing the complaint is granted.

PRESENT: PESCE, P.J., GOLIA and STEINHARDT, JJ.


In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground that plaintiff had failed to appear for scheduled examinations under oath (EUOs) or, in the alternative, that plaintiff's action was premature, in that plaintiff had not provided requested additional verification. Plaintiff submitted no written opposition to defendant's motion. The Civil Court denied defendant's motion, finding that the EUO scheduling letters were inadequate because they did not delineate the place and location of the EUO in a conspicuous manner, "i.e. bold or larger font," and that defendant had failed to establish plaintiff's nonappearance at the EUOs. This appeal by defendant ensued.

The affidavits submitted by defendant established that the EUO scheduling letters were timely mailed in accordance with the affiants' employers' standard office practices and procedures ( see St. Vincent's Hosp. of Richmond v Government Empls. Ins. Co. , 50 AD3d 1123 ; Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins. , 17 Misc 3d 16 [App Term, 2d 11th Jud Dists 2007]). Defendant also submitted an affirmation from one of its attorneys, who was responsible for conducting the EUOs at issue. He alleged facts sufficient to establish that plaintiff had failed to appear at counsel's former law office for duly scheduled EUOs ( see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co. , 35 AD3d 720 ; W Z Acupuncture, P.C. v Amex Assur. Co. , 24 Misc 3d 142[A], 2009 NY Slip Op 51732[U] [App Term, 2d, 11th 13th Jud Dists 2009]). Such an appearance at an EUO is a condition precedent to the insurer's liability on the policy ( see Insurance Department Regulations [ 11 NYCRR] § 65-1.1; Stephen Fogel Psychological, P.C., 35 AD3d at 722; Crotona Hgts. Med., P.C. v Farm Family Cas. Ins. Co. , 27 Misc 3d 134[A], 2010 NY Slip Op 50716[U] [App Term, 2d, 11th 13th Jud Dists 2010]). Further, contrary to the Civil Court's determination, there is no requirement that EUO scheduling letters conspicuously highlight the time and place of the EUO by use of, among other things, a bold or larger font ( see Insurance Department Regulations [ 11 NYCRR] § 65-3.5 [b], [e]). Accordingly, the order is reversed and defendant's motion for summary judgment dismissing the complaint is granted. In light of the foregoing, we reach no other issue.

Pesce, P.J., Golia and Steinhardt, JJ., concur.


Summaries of

GLM Med. v. State Farm Mut. Auto. Ins.

Appellate Term of the Supreme Court of New York, Second Department
Feb 14, 2011
2011 N.Y. Slip Op. 50194 (N.Y. App. Term 2011)
Case details for

GLM Med. v. State Farm Mut. Auto. Ins.

Case Details

Full title:GLM MEDICAL, P.C. as Assignee of MARIE THADAL, Respondent, v. STATE FARM…

Court:Appellate Term of the Supreme Court of New York, Second Department

Date published: Feb 14, 2011

Citations

2011 N.Y. Slip Op. 50194 (N.Y. App. Term 2011)