Key Takeaway
Court rules that challenges to EUO reasonableness are waived without timely objection, establishing key precedent for no-fault insurance defense strategies.
Crescent Radiology, PLLC v American Tr. Ins. Co., 2011 NY Slip Op 50622(U)(App. Term 2d Dept. 2011)
“The papers substantiate the basis for the EUO request. Moreover, plaintiff does not claim to have responded in any way to defendant’s request for an EUO. Therefore, plaintiff will not be heard to complain that there was no reasonable basis for the EUO request (cf. Westchester County Med. Ctr. v New York Cent. Mut. Fire Ins. Co., 262 AD2d 553 ; Urban Radiology, P.C. v Tri-State Consumer Ins. Co., 27 Misc 3d 140, 2010 NY Slip Op 50987 ; Mary Immaculate Hosp. v New York Cent. Mut. Fire Ins. Co., 21 Misc 3d 130, 2008 NY Slip Op 52046 ).”
This is an important case, and I think it can be read two ways. First, it can be read to require that an objective basis be necessary to compel the attendance at an EUO, but that inquiry is waived without an objection. Second, it can be read to require that an objection be lodged prior to a “reasonableness” inquiry being considered.
Since the DOI has opined that an objective basis inquiry has no bearing on whether to substantiate the validity of the EUO demand, it would seem that the court is therein discussing the reasonableness inquiry. That being said, the prudent plaintiff attorney should (and usually does) communicate with the insurance carrier explaining why the EUO is improper, following receipt of the demand. Similarly, the insurance carrier should promptly respond to the plaintiff’s objection letter explaining why the EUO is reasonable or justified. At that point, the ball is in the plaintiff’s court to decide what to do.
Related Articles
- Understanding EUO Denial: When Insurance Companies Can Substantiate Coverage Denials
- Summary judgment granted on EUO no-show defense – interesting analysis
- Discovery disallowed when EUO requests are not responded to by deponent
- EUO no-show defense sustained
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2011 decision, New York appellate courts have issued additional rulings on EUO waiver principles and objection requirements that may have refined or clarified the standards discussed here. Additionally, Department of Financial Services regulatory interpretations regarding EUO procedures and reasonable basis standards may have evolved. Practitioners should verify current case law and regulatory guidance when advising clients on EUO objection timing and waiver issues.
