Key Takeaway
A 2012 case highlights how insurance companies must properly establish EUO scheduling to avoid losing their right to deny claims based on no-shows.
In New York no-fault insurance litigation, insurance companies frequently rely on examinations under oath (EUOs) as a crucial tool for investigating potentially fraudulent claims. When claimants fail to appear for scheduled EUOs, insurers often believe they have a strong defense for denying coverage. However, a 2012 Appellate Term decision demonstrates that the foundation for such defenses must be properly established from the outset.
The case of Superior Oxygen & Ortho Supplies, Ltd. v Auto One Ins. Co. serves as a cautionary tale for insurance carriers who fail to follow proper procedures when scheduling EUOs. This decision underscores the importance of meticulous compliance with regulatory requirements, particularly the timing and proof of EUO scheduling notices. When insurers cut corners on these procedural steps, they risk losing what might otherwise be valid defenses, even when dealing with EUO no-shows or cases involving questionable claim submissions.
Jason Tenenbaum’s Analysis:
Superior Oxygen & Ortho Supplies, Ltd. v Auto One Ins. Co., 2012 NY Slip Op 50348(U)(App. Term 2d Dept. 2012)
“defendant failed to establish that the examination under oath (EUO) scheduling letters had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ) and that the 30-day claim determination period (see Insurance Department Regulations § 65-3.8) had been tolled. As a result, defendant failed to establish that its denial of claim forms were timely and, thus, that it is not precluded from raising the failure of plaintiff’s assignors to appear at the EUOs as a defense”
The case speaks for itself and the result should validate a more proactive method to handling these cases. Otherwise, why are you paying your attorneys to do these EUO’s?
Key Takeaway
This decision reinforces that insurance companies cannot simply rely on the fact that claimants failed to appear for EUOs. Proper documentation of timely mailing and compliance with regulatory deadlines is essential. Without establishing these foundational elements, insurers may find themselves precluded from asserting otherwise valid defenses, regardless of whether Allstate or other carriers face similar procedural challenges in New York no-fault insurance law cases.
Legal Update (February 2026): Since this 2012 post, New York’s no-fault insurance regulations under 11 NYCRR § 65 have undergone several amendments affecting EUO procedures, timing requirements, and proof standards for scheduling notices. Additionally, appellate decisions over the past 14 years may have refined the procedural requirements for establishing proper EUO scheduling and the consequences of non-compliance. Practitioners should verify current regulatory provisions and recent case law developments when handling EUO no-show situations and coverage denials.
