Proof of Failure to Appear for EUO is Sufficient to Void Coverage and Defeat Claims of Health Care Providers

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In a declaratory judgment action, the plaintiff moved for summary judgment against defendants New York City Health and Hospitals d/b/a Queens Hospital Center et al. The plaintiff sought a declaration that it is not obligated to pay no-fault benefits to it to reimburse the defendants for claims made for treatment rendered or medical equipment provided to the individual defendant, Tasha Williams, for injuries allegedly sustained in an auto accident because the grounds that Williams failed to appear for duly scheduled Examinations Under Oath (EUOs).

ZALMA OPINION

The EUO is an important tool available to insurers to allow the insured and the insured’s assignees to prove the claims presented under New York’s no-fault law. The refusal to appear to a duly noticed demand for EUO and a rescheduled EUO is sufficient to refuse to pay, and in New York voids the policy from its inception.