June 6, 2016

Omphil Care, Inc. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50899(U))

https://www.beynensonlaw.com/case-law/omphil-care-inc-v-state-farm-mut-auto-ins-co-2016-ny-slip-op50899u/

Court
Appellate Term, Second Department
Decided
June 6, 2016
Citation
2016 NY Slip Op 50899(U) · 52 Misc 3d 126(A)
Posture
Summary judgment
Outcome
Insurer prevailed
Issues
EUO no-show
Cite as
Omphil Care, Inc. v State Farm Mut. Auto. Ins. Co., 52 Misc 3d 126(A), 2016 NY Slip Op 50899(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016)

Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.

Summary

Editorial summary by Beynenson Law, not part of the court’s decision.

The insurer's summary judgment dismissing the provider's claims for failure to appear for duly scheduled EUOs was affirmed. The Appellate Term, Second Department, upheld the Civil Court's order for the reasons stated in the companion appeal, Vladenn Med. Supply Corp. v State Farm Mut. Auto. Ins. Co., decided the same day, No. 2013-2364 Q C.

Reported in New York Official Reports at Omphil Care, Inc. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50899(U))

[*1]
Omphil Care, Inc. v State Farm Mut. Auto. Ins. Co.
2016 NY Slip Op 50899(U) [52 Misc 3d 126(A)]
Decided on June 6, 2016
Appellate Term, Second Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
This opinion is uncorrected and will not be published in the printed Official Reports.

Decided on June 6, 2016

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS


PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-2439 Q C
Omphil Care, Inc., as Assignee of FRANTZ MENARD, Appellant,

against

State Farm Mutual Automobile Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (William A. Viscovich, J.), entered September 12, 2013. The order granted defendant’s motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant’s motion for summary judgment dismissing the complaint. The Civil Court found that defendant had timely and properly denied the claims at issue on the ground that plaintiff had failed to comply with a condition precedent to coverage, in that plaintiff had failed to appear for duly scheduled examinations under oath (EUOs). On appeal, plaintiff argues that defendant failed to prove that it had mailed its EUO scheduling letters and denial of claim forms, or that plaintiff had failed to appear for the EUOs; that defendant lacked justification for its EUO requests; that defendant’s motion should have been denied pursuant to CPLR 3212 (f), as plaintiff had not received discovery regarding the reasonableness of defendant’s EUO requests; and that defendant failed to prove that plaintiff had willfully obstructed defendant’s investigation.

For the reasons stated in Vladenn Med. Supply Corp., as Assignee of Sonie Jeanty v State Farm Mut. Auto. Ins. Co. (___ Misc 3d ___, 2016 NY Slip Op ____ [appeal No. 2013-2364 Q C], decided herewith), the order is affirmed.

Pesce, P.J., Aliotta and Solomon, JJ., concur.


Decision Date: June 06, 2016

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