Omphil Care, Inc. v. State Farm Mut. Auto. Ins. Co.

Appellate Terms of the Supreme Court of New York

Omphil Care, Inc. v. State Farm Mut. Auto. Ins. Co.

CourtAppellate Terms of the Supreme Court of New York

DecidedJune 6, 2016

Docket2016 NYSlipOp 50899(U)

StatusPublished

This text of Omphil Care, Inc. v. State Farm Mut. Auto. Ins. Co. (Omphil Care, Inc. v. State Farm Mut. Auto. Ins. Co.) is published on Counsel Stack Legal Research, covering Appellate Terms of the Supreme Court of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Omphil Care, Inc. v. State Farm Mut. Auto. Ins. Co., (N.Y. Ct. App. 2016).

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Opinion

Omphil Care, Inc., as Assignee of FRANTZ MENARD, Appellant,

against

State Farm Mutual Automobile Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (William A. Viscovich, J.), entered September 12, 2013. The order granted defendant's motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant's motion for summary judgment dismissing the complaint. The Civil Court found that defendant had timely and properly denied the claims at issue on the ground that plaintiff had failed to comply with a condition precedent to coverage, in that plaintiff had failed to appear for duly scheduled examinations under oath (EUOs). On appeal, plaintiff argues that defendant failed to prove that it had mailed its EUO scheduling letters and denial of claim forms, or that plaintiff had failed to appear for the EUOs; that defendant lacked justification for its EUO requests; that defendant's motion should have been denied pursuant to CPLR 3212 (f), as plaintiff had not received discovery regarding the reasonableness of defendant's EUO requests; and that defendant failed to prove that plaintiff had willfully obstructed defendant's investigation.

For the reasons stated in Vladenn Med. Supply Corp., as Assignee of Sonie Jeanty v State Farm Mut. Auto. Ins. Co. (___ Misc 3d ___, 2016 NY Slip Op ____ [appeal No. 2013-2364 Q C], decided herewith), the order is affirmed.

Pesce, P.J., Aliotta and Solomon, JJ., concur.

Decision Date: June 06, 2016

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Omphil Care, Inc., as Assignee of FRANTZ MENARD, Appellant,

against

State Farm Mutual Automobile Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (William A. Viscovich, J.), entered September 12, 2013. The order granted defendant's motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant's motion for summary judgment dismissing the complaint. The Civil Court found that defendant had timely and properly denied the claims at issue on the ground that plaintiff had failed to comply with a condition precedent to coverage, in that plaintiff had failed to appear for duly scheduled examinations under oath (EUOs). On appeal, plaintiff argues that defendant failed to prove that it had mailed its EUO scheduling letters and denial of claim forms, or that plaintiff had failed to appear for the EUOs; that defendant lacked justification for its EUO requests; that defendant's motion should have been denied pursuant to CPLR 3212 (f), as plaintiff had not received discovery regarding the reasonableness of defendant's EUO requests; and that defendant failed to prove that plaintiff had willfully obstructed defendant's investigation.

For the reasons stated in Vladenn Med. Supply Corp., as Assignee of Sonie Jeanty v State Farm Mut. Auto. Ins. Co. (___ Misc 3d ___, 2016 NY Slip Op ____ [appeal No. 2013-2364 Q C], decided herewith), the order is affirmed.

Pesce, P.J., Aliotta and Solomon, JJ., concur.

Decision Date: June 06, 2016

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Omphil Care, Inc. v. State Farm Mut. Auto. Ins. Co., Counsel Stack Legal Research, https://law.counselstack.com/opinion/omphil-care-inc-v-state-farm-mut-auto-ins-co-nyappterm-2016.