Key Takeaway
NY Appellate Term rules EUO letters need not use large fonts. Important decision for Long Island & NYC medical providers on no-fault insurance requirements. Call 516-750-0595.
Understanding EUO Letter Requirements in New York No-Fault Insurance Cases
When dealing with New York’s no-fault insurance system, medical providers and attorneys frequently encounter disputes over Examinations Under Oath (EUO) requirements. A recent Appellate Term decision has clarified an important aspect of EUO scheduling letters that has implications for both insurance companies and healthcare providers across Long Island and New York City.
The case of GLM Med., P.C. v State Farm Mut. Auto. Ins. Co., 2011 NY Slip Op 50194(U)(App. Term 2d Dept. 2011) provides crucial guidance on what constitutes adequate notice for EUO scheduling.
The Court’s Decision on Font Requirements
In an affront to those who have blurry vision and can only see large print, the Appellate Term rebuffed Judge Garson’s denial of a summary judgment predicated upon EUO defaults because the print on the letters was not large and in bold. According to the Appellate Term: “Further, contrary to the Civil Court’s determination, there is no requirement that EUO scheduling letters conspicuously highlight the time and place of the EUO by use of, among other things, a bold or larger font”. I am just thinking that if certain attorneys can become millionaires for suing restaurants and move theaters because a certain seat or bench is a centimeter outside the acceptable range for ADA purposes, why should this be any different?
The above said, the Court was correct in holding how it did. Did anybody see the hidden gem in this case?
“In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground that plaintiff had failed to appear for scheduled examinations under oath (EUOs) or, in the alternative, that plaintiff’s action was premature, in that plaintiff had not provided requested additional verification.”
I have never seen that before.
Legal Standards for EUO Notice Requirements
The Appellate Term’s decision establishes that insurance companies are not required to use special formatting such as bold fonts, larger print, or other conspicuous highlighting when scheduling EUOs. This ruling provides clarity for insurance carriers operating throughout Nassau County, Suffolk County, Queens, Brooklyn, and the Bronx who have been uncertain about formatting requirements.
For medical providers in Long Island and New York City, this means that EUO notices cannot be challenged solely on the basis of font size or formatting. The focus must remain on whether the notice provides adequate information about the time, date, and location of the examination.
Implications for Medical Providers
Healthcare providers who receive EUO notices should pay careful attention to the content rather than the formatting. Key elements that must be included in valid EUO notices include:
- Clear identification of the examination date and time
- Specific location where the EUO will take place
- Contact information for rescheduling if necessary
- Consequences of failing to appear
Medical practices across Nassau and Suffolk Counties should establish clear procedures for handling EUO notices to ensure compliance and avoid potential claim denials.
The ADA Litigation Connection
The court’s observation about ADA litigation raises an interesting parallel. While accessibility requirements in public accommodations are strictly enforced, with minor deviations potentially resulting in significant liability, EUO notices are held to different standards. This distinction reflects the different policy goals underlying each area of law.
Why Font Requirements Don’t Apply to EUO Notices
Unlike public accommodation requirements under the Americans with Disabilities Act, EUO notices are governed by New York’s no-fault insurance regulations and common law notice requirements. The focus is on whether reasonable notice was provided, not whether the notice accommodates all possible visual impairments.
Insurance companies can rely on standard business correspondence practices when sending EUO notices, provided the essential information is clearly communicated. This approach balances the need for proper notice with practical business considerations.
The Hidden Alternative Ground for Summary Judgment
Perhaps more significant than the font size issue is the court’s recognition of an alternative ground for summary judgment: that the plaintiff’s action was premature due to failure to provide requested additional verification. This represents a developing area of no-fault law that medical providers should understand.
Additional Verification Requirements
When insurance companies request additional verification of claims, medical providers must comply before pursuing litigation. Failure to provide requested verification can result in a finding that the lawsuit was prematurely filed, even if the provider later appears for the EUO.
This dual-track approach gives insurance companies two potential defenses when dealing with non-compliant providers:
- EUO non-appearance leading to claim denial
- Premature litigation due to incomplete verification
Best Practices for Medical Providers in Long Island and NYC
Given this legal landscape, medical providers should adopt the following practices:
Document Review and Response
- Carefully review all correspondence from insurance companies
- Respond promptly to verification requests
- Maintain detailed records of all communications
- Ensure EUO appearances are calendared and confirmed
Legal Compliance Strategy
- Don’t rely on formatting challenges to EUO notices
- Focus on substantive compliance with no-fault requirements
- Consider legal counsel for complex verification disputes
- Implement office procedures for handling insurance requests
Frequently Asked Questions About EUO Requirements
Q: Can I challenge an EUO notice because the font is too small?
A: No. The Appellate Term has specifically ruled that there is no requirement for EUO scheduling letters to use bold or larger fonts to highlight the examination details.
Q: What happens if I miss an EUO due to unclear notice?
A: Missing an EUO can result in claim denial. However, you may be able to challenge the adequacy of the notice based on substantive deficiencies in the information provided, not formatting issues.
Q: Can an insurance company pursue summary judgment on multiple grounds?
A: Yes. As this case demonstrates, insurance companies can argue both EUO non-appearance and premature litigation due to incomplete verification as alternative grounds for dismissal.
Q: How should my practice handle verification requests from insurance companies?
A: Respond promptly and completely to all verification requests. Failure to provide requested verification can result in a finding that any subsequent lawsuit was prematurely filed.
Q: Are there different requirements for providers in different boroughs?
A: No. The no-fault insurance requirements apply uniformly across New York State, including all of Long Island, New York City, and the surrounding areas.
Moving Forward: Practical Implications for No-Fault Practice
This decision clarifies that insurance companies have flexibility in how they format EUO notices, while medical providers must focus on substantive compliance rather than procedural challenges based on formatting. The recognition of premature litigation as an alternative ground for summary judgment adds another layer of complexity to no-fault disputes.
For medical practices throughout Nassau County, Suffolk County, and the five boroughs of New York City, the key takeaway is the importance of maintaining rigorous compliance procedures. Rather than looking for technical defenses, providers should focus on meeting their obligations under the no-fault system.
This case also highlights the evolving nature of no-fault law and the importance of staying current with appellate decisions that can impact practice procedures and litigation strategies.
Contact a No-Fault Insurance Attorney
If your medical practice is dealing with EUO requirements, claim denials, or verification disputes, experienced legal counsel can help protect your interests. Understanding the nuances of no-fault insurance law is crucial for maintaining a successful healthcare practice in New York.
For assistance with no-fault insurance matters, EUO compliance, or claim disputes, contact our experienced legal team at 516-750-0595. We represent medical providers throughout Long Island and New York City in all aspects of no-fault insurance law.
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- EUO no-show and verification non-receipt issues
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2011 decision, New York’s no-fault insurance regulations and EUO procedural requirements may have been amended through regulatory updates or subsequent court decisions. Practitioners should verify current provisions regarding EUO notice requirements, formatting standards, and any accessibility accommodation mandates that may now apply to insurance correspondence.
