Source: http://jtnylaw.com/category/persona-knowledge-of-no-show/
Timestamp: 2019-04-20 21:18:57+00:00

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This all came about at the famous trial in front of Judge Levine a few years ago. Michael Kopelevich I think was the attorney for the provider. The question raised was who is Lynn Carter an MCMC stated she did not exist. This is probably not a good marketing technique for an IME vendor.
Why Lynn Carter? Do we have Dixie Carter , Jimmy Carter or Gary Carter fans at MCMC?
I am not sure what to make of these two decisions. Read them yourself. I think Alrof is wrong. The Appellate Division in Lucas rejected it and the Appellate Term, Second Department in Quality v. Interboro clearly will not hold it as sacrosanct when a proper practice and procedure affidavit is presented.
This is perhaps the DJ of the year so far. So many principles of law have been established and/or confirmed. First, the medical provider and or assignor must cooperate with the EUO, i.e., attend it and answer questions. Second, the failure to cooperate during the EUO through walking out during it, objecting too many times, engaging in obstructionist behavior can lead to a violation of a condition precedent to coverage, provided Park v. Long Island Insurance Company warnings are set forth.
The unsettled question that may play out now is: what constitutes obstructionist behavior? We know the outter bounds of what constitutes this behavior. But, how many objections is required before a disclaimer may be issued? What happens if an EIP or medical provider lies during the EUO? How does Utica v. Timms (you can lie and not lose your benefits) work into this equation? There a lot of unanswered questions. In my mind, the extremes will allow for a disclaimer. Misrepresentations and a few inappropriate objections will probably not trigger a Huff remedy.
On top of that, the contents of the EUO transcript are admissible without further foundation against the medical provider. Counsel for Defendant was successful at making that argument in Civil Court Kings County against me a few years ago, i.e., you cannot use the contents of the EUO transcript against the innocent assignee. I thought it was an incredulous argument, which would be shot down at the Appellate Term or Appellate Division.
Funny enough, counsel in the Civil Kings case pressed his luck in front of the First Department and rightfully saw what five learned jurists had to say about that argument. These are all good things in my mind.
I believe that this case is probably somewhere between the ATIC dj appeals and Unitrin as to its precedential value.
Seems to be the same cohorts that draw Alrof citations. In my mind, after you lose, change the affidavits. Appealing the same losing affidavits is insane and helps nobody. The definition of insanity is to do the same thing over and over again and to expect a different result.
Putting aside certain disdain towards the Second Department punting the “absolute coverage” component of Unitrin and ATIC v. Lucas, the IDS case said that when carrier wants an EUO of whoemever, no is not a suitable answer. The case also spoke about “partial performance”, which probably means showing up to the EUO. I am not sure what needs to be answered to constitute partial performance, although answering relevant questions would seem to fit the bill.
Note: “assuming arguendo”. Read this how you want, but I think assuming arguendo leads to a certain result.
If you follow this blog, you will know that “Alrof” is not really good law. For reasons I am not even going to discuss on here, I ended up challenging this proposition of law and prevailed on it. The First Department (ATIC v. Lucas), the Second Department (Interboro v. Clennon) and this Court (Quality v. Interboro; Ortho Products v. Interboro) have all found that Alrof does not mean what it says.
But, in this Court, if you wish to resurrect W&Z v. Amex, the affidavit from the “partner” had better lead that horse to water and make it drink it. And, it is not the quantity of verbiage that is in the affirmation which will win the day, it is how you present it, lay it out and assert it.
Standard EUO no-show motion. However, the issue (among others) involved the proof of no-show. Is a certified EUO bust statement sufficient to prove the no-show? The answer is yes and the complaint is dismissed.

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