GMR Senior Associate Zachary Whiting secured a summary judgment victory in New York County Supreme Court in a first-party coverage dispute arising from a 2021 motor vehicle accident. The Court held that the insurer had no obligation to provide coverage based on its founded belief that the claimed injuries were not related to the accident.
The Court’s decision recognized the strength of the insurer’s investigation, including significant inconsistencies in the accounts of how the accident occurred, injuries that appeared disproportionate to the minor vehicle damage, and the defendant’s failure to appear for an Examination Under Oath. The Court also rejected challenges to the insurer’s evidence, finding that certified EUO transcripts and affirmations based on personal knowledge and independently corroborated information were sufficient to support summary judgment in a first-party coverage matter.
The decision highlights the importance of a thorough SIU investigation and effective EUO follow-through. When potential fraud indicators are carefully investigated and properly documented, that evidence can be critical to establishing a founded belief and successfully defeating an unsupported coverage claim.
