Our client, State Farm Insurance Company, properly denied claims for medical services submitted by the plaintiff for treatment allegedly provided to its assignor. Plaintiff, the medical provider, sued to recover first party no-fault benefits in the Suffolk County District Court. State Farm denied the claims in this matter based upon the plaintiff’s failure to appear for two scheduled Examinations Under Oath (EUO), a condition precedent to coverage under New York no-fault law.
On behalf of State Farm, our firm made a pre-answer motion to dismiss, and the court granted our motion. One of plaintiff’s arguments was that State Farm’s EUO demand letters were palpably improper due to certain documentation demanded in the verification request and the location of the EUO. The Honorable C. Stephen Hackeling, citing Canarsie Chiropractic, P.C. v. State Farm Mut. Fire Ins. Co., 27 Misc. 3d 1228A (Civ. Ct., Kings County 2010) (a decision also obtained by our office), found that plaintiff was required to communicate any defect in the EUO letters, rather than simply ignore the requests. To read the printed decision, click here.
The use of a pre-answer motions to dismiss is an extremely beneficial tool we use for our clients to provide a swift and economical result in cases where, as here, the medical provider or the eligible injured person breached a condition precedent to coverage under New York’s No-Fault law.