X

Thank you for sharing!

Your article was successfully shared with the contacts you provided.

Recitation, as Required by CPLR 2219 (A), of The Papers Considered in the Review of This Motion:Notice of Motion  1Notice of Cross-Motion       2Answering AffidavitReply AffidavitDECISION AND ORDER Defendant moves for summary judgment dismissing the complaint based on plaintiff’s failure to attend an examination under oath. Plaintiff cross-moves for summary judgment in its favor, or in the alternative, for an order pursuant to CPLR 3212(g), finding that the bills at issue were mailed to and received by defendant.Defendant contends that plaintiff’s failure to attend an EUO violates a condition precedent to defendant’s liability, mandating dismissal.While plaintiff’s non-appearance at an EUO vitiates defendant’s obligation to provide coverage (see Stephen Fogel Psychological, P.C. v. Progressive Cas. Ins. Co., 35 A.D.3d 720, 827 N.Y.S.2d 217, 2006 N.Y. Slip Op 09604 [2nd Dept 2006]), to show entitlement to summary judgement, defendant must prove that it properly mailed the EUO requests to the plaintiff, who failed to appear for the EUO, and that defendant mailed plaintiff a timely denial. (See Interboro Ins. Co. v. Clennon, 113 A.D.3d 596, 979 N.Y.S.2d 83, 2014 N.Y. Slip Op 00092 [2nd Dept 2014]).Proof of mailing may be shown based on actual mailing or that the item was mailed pursuant to the affiant’s standard office practices and procedures designed to ensure proper mailing (see St. Vincent’s Hosp. of Richmond v. Government Empls. Ins. Co., 50 A.D.3d 1123, 857 N.Y.S.2d 211, 2008 N.Y. Slip Op 04072 [2d Dept 2008]).To establish the proper mailing procedure of the EUO requests and the denials, defendant submits an affidavit from Ms. Ulmer, stating that EUO requests and denials are assigned identifying numbers, then printed and placed in envelopes that are stamped by a “mail machine,” and kept in the mailing room, until delivered to United States Postal Service on the same date the documents were generated.The affidavit, however, fails to establish that the afore-described procedure was designed to ensure that the EUO letters and denials were addressed to the correct recipient and properly mailed (see Progressive Cas. Ins. Co. v. Infinite Ortho Prods., Inc., 127 A.D.3d 1050, 7 N.Y.S.3d 429, 2015 N.Y. Slip Op 03340 [2d Dept 2015]).Specifically, the affidavit does not indicate if the envelopes are addressed by a computer program or by an employee, how the envelopes are addressed to ensure the accuracy of the recipient’s address, and in what manner the envelopes are weighed and affixed with proper postage using the “mail machine.” As there is insufficient information to enable judicial review of the propriety of defendant’s mailing procedure, defendant fails to meet its burden that the EUO requests and the denials, were properly mailed to the plaintiff.As defendant failed to establish entitlement to judgment as a matter of law on the issues of proper mailing of the EUO letters and denials, its motion for summary judgment is denied regardless of the sufficiency of plaintiff’s opposition (see Stephen Fogel Psychological, P.C. v. Progressive Cas. Ins. Co., 35 A.D.3d 720, 827 N.Y.S.2d 217, N.Y. Slip Op 09604 [2d Dept 2006], affg 7 Misc.3d 18 [App Term, 2d Dept 2004]).The cross motion for granting plaintiff summary judgment is further denied, as plaintiff failed to establish that defendant’s denials were conclusory, vague or otherwise defective (see Megacure Acupuncture P.C. v. Clarendon Natl. Ins. Co., 33 Misc.3d 141(A), 941 N.Y.S.2d 538, 2011 N.Y. Slip Op 52199(U) [App Term, 2d, 11th & 13th Jud Dists, 2011]). However, plaintiff’s cross-motion pursuant to pursuant to CPLR 3212(g) is granted to the extent that the bills at issue were mailed to and received by defendant.Dated: December 20, 2018

 
Reprints & Licensing
Mentioned in a Law.com story?

License our industry-leading legal content to extend your thought leadership and build your brand.

More From ALM

With this subscription you will receive unlimited access to high quality, online, on-demand premium content from well-respected faculty in the legal industry. This is perfect for attorneys licensed in multiple jurisdictions or for attorneys that have fulfilled their CLE requirement but need to access resourceful information for their practice areas.
View Now
Our Team Account subscription service is for legal teams of four or more attorneys. Each attorney is granted unlimited access to high quality, on-demand premium content from well-respected faculty in the legal industry along with administrative access to easily manage CLE for the entire team.
View Now
Gain access to some of the most knowledgeable and experienced attorneys with our 2 bundle options! Our Compliance bundles are curated by CLE Counselors and include current legal topics and challenges within the industry. Our second option allows you to build your bundle and strategically select the content that pertains to your needs. Both options are priced the same.
View Now
November 27, 2024
London

Celebrating achievement, excellence, and innovation in the legal profession in the UK.


Learn More
December 02, 2024 - December 03, 2024
Scottsdale, AZ

Join the industry's top owners, investors, developers, brokers and financiers for the real estate healthcare event of the year!


Learn More
December 11, 2024
Las Vegas, NV

This event shines a spotlight on how individuals and firms are changing the investment advisory industry where it matters most.


Learn More

FEDERAL PUBLIC DEFENDER VACANCY MIDDLE DISTRICT OF PENNSYLVANIA Refer to: www.ca3.uscourts.gov for detailed announcement...


Apply Now ›

The Business Litigation Group of the Boston office of McCarter & English seeks a litigation associate with 3-5 years of business litigat...


Apply Now ›

McCarter and English is actively seeking a trusts and estates associate for our Newark, NJ office with 3-5 years of experience in estate pla...


Apply Now ›