In Unitrin Advantage Ins. Co. v. Andrew J. Dowd, MD., 2021 N.Y. Slip Op. 03012, a No-Fault automobile insurer appealed an arbitration award in favor of a medical provider. The insurer had disclaimed coverage on the ground that the provider’s failed to appear for examinations under oath (“EUOs”). The arbitrator found that the EUOs were not timely requested. The New York Appellate Division, First Department, reversed summary judgment granted by the lower court. The Appellate Division also awarded the insurer summary judgment on its disclaimer, holding that the EUOs were timely requested. The decision is significant because it allows insurers to retroactively deny all coverage where a provider fails to comply with a condition of coverage.
