ACCELERATED MEDICAL SUPPLY INC v. AMERIPRISE INSURANCE COMPANY (2020)

ORDERED that the judgment is reversed, without costs, the order dated April 12, 2017 is vacated, defendant's motion for summary judgment dismissing the complaint is granted and plaintiff's cross motion for summary judgment is denied.

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 it had timely denied the claims based upon plaintiff's failure to appear for duly scheduled examinations under oath (EUOs), and plaintiff cross-moved for summary judgment. In an order dated April 12, 2017, the District Court denied defendant's motion, finding that the letters scheduling the EUOs of plaintiff were defective because they did not specify the claims to which the letters pertained, and the court granted plaintiff's cross motion. A judgment awarding plaintiff the principal sum of $3,337 was entered on August 16, 2017 pursuant to the April 12, 2017 order.

Defendant established that the EUO scheduling letters had been properly mailed (see St. Vincent's Hosp. of Richmond v. Government Empls. Ins. Co., 50 AD3d 1123 [2008]).

“Contrary to the finding by the District Court, the EUO scheduling letters were not ‘defective.’ We note that the initial EUO scheduling letter identified the assignor, the date of the accident and defendant's file number. The initial EUO scheduling letter resulted in a toll of defendant's time to pay or deny plaintiff's claims as to each claim form which had been submitted by the same plaintiff for the same assignor and accident prior to the EUO request, as long as the request had been timely with respect to such claim, and to any claim form received subsequent to that request, but before plaintiff breached a policy condition by failing to appear for two properly scheduled EUOs (see ARCO Med. NY, P.C. v. Lancer Ins. Co., 34 Misc 3d 134[A], 2011 NY Slip Op. 52382[U] [App. Term, 2d Dept, 2d, 11th & 13th Jud. Dists 2011]; see also Tsatkis v. State Farm Fire & Cas. Co., 36 Misc 3d 129[A], 2012 NY Slip Op. 51268[U] [App. Term, 2d Dept, 9th & 10th Jud Dists 2012] ). Defendant further established that plaintiff had failed to appear for the duly scheduled EUOs (see Stephen Fogel Psychological, P.C. v. Progressive Cas. Ins. Co., 35 AD3d 720 [2006]) and that defendant had timely mailed (see St. Vincent's Hosp. of Richmond, 50 AD3d 1123) its denial of claim forms denying the claims on that ground. In opposition, plaintiff failed to raise a triable issue of fact” (First Class Med., P.C. v. Ameriprise Ins. Co., 63 Misc. 3d 135[A], 2019 NY Slip Op. 50477[U], *1-2 [App. Term, 2d Dept, 9th & 10th Jud Dists 2019] ).

Accordingly, the judgment is reversed, the order dated April 12, 2017 is vacated, defendant's motion for summary judgment dismissing the complaint is granted and plaintiff's cross motion for summary judgment is denied.

ADAMS, P.J., TOLBERT and RUDERMAN, JJ., concur.