Nationwide Insurance Company of America, et al. v. Medical Supply Depot Group Corp.,

Index # 005587/2020

Supreme Court – New York – Onondaga County

In Nationwide Insurance Company of America, et al. v. Medical Supply Depot Group Corp., the insurer filed an action in the Supreme Court, Onondaga County seeking a declaration that it has no obligation to pay certain claims as Plaintiff breached a condition precedent to coverage by failing to appear for an examination under oath (“EUO”).  The insurer thereafter moved for summary judgement which was granted.  Despite the medical provider’s argument that the insurer must provide a reasonable basis for an EUO request, the Court ruled that an insurer bears no such burden to establish its entitlement to summary judgement.  More importantly, the Court disagreed with the medical provider’s argument that an insurer must deny a claim within 30 days of the second missed EUO – an issue widely and recently often contested.  In citing to a line of cases wherein the Appellate Division (First and Fourth Departments) sustained the insurers’ denials after three or more (even seven) missed IMEs and/or EUOs, the Court concluded that the medical provider’s position was not supported by any controlling law.  The decision can be accessed here:

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