GMR Wins Summary Judgment in New York for Insurer Denying Plaintiff’s Medical Claims

GMR Attorney Victoria Tarasova and Senior Counsel Lindsay Padover successfully obtained summary judgment seeking a declaration that medical providers were not entitled to claims submitted for the plaintiff’s treatment. Lindsay prepared the motion, and Victoria argued it.

GMR promptly and vigorously pursued the plaintiff’s Examination Under Oath (“EUO”)  to question her regarding the treatment. Plaintiff never appeared for her EUO.  Victoria argued that cooperation regarding the EUO was a condition precedent to coverage that entitled the company to deny all claims retroactively to the date of loss. The defendants argued that the insurer was required to pay a claim or issue a denial within (30) days of the receipt of the claim. They also argued that the requests were not timely and that plaintiff lacked good and objective justification for requesting the EUO.

The Court granted GMR’s MSJ, agreeing with Victoria and Lindsay’s position that the EUO requests were timely and in good faith. Thus,  the insurer had no duty to pay any No-Fault benefits to any provider defendants.