Key Takeaway
New York court rules that insurance company's EUO request for medical provider was untimely, failing to comply with 15-day requirement under no-fault regulations.
This article is part of our ongoing euo issues coverage, with 323 published articles analyzing euo issues issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Understanding the Timing Requirements for Medical Provider EUOs in No-Fault Cases
In New York’s no-fault insurance system, timing is everything. Insurance companies must follow strict deadlines when requesting additional verification from healthcare providers, including examinations under oath (EUOs). A recent appellate decision demonstrates how missing these deadlines can derail an insurer’s defense strategy and leave them liable for outstanding medical bills.
The case of Quality Psychological Services v. Utica Mutual Insurance Company highlights a critical procedural requirement that many insurers overlook: the 15-day window for requesting provider EUOs following an injured person’s examination. This timing rule, rooted in New York No-Fault Insurance Law, serves to protect healthcare providers from indefinite uncertainty about payment while ensuring insurers can still conduct necessary investigations within reasonable timeframes.
Jason Tenenbaum’s Analysis:
Quality Psychological Servs., P.C. v Utica Mut. Ins. Co., 2013 NY Slip Op 50148(U)(App. Term 1st Dept. 2013)
“We sustain the denial of defendant’s motion for summary judgment dismissing this first-party no-fault action. Defendant’s June 26, 2008 request for additional verification in the form of an examination under oath (EUO) of the plaintiff medical provider was untimely and did not serve to toll defendant’s time to pay or deny the claim, since the request was made well beyond the requisite 15-day time period following the assignor’s EUO”
Unitrin held that the IMEs (and EUOs through subsequent case law) must be in accordance with the no-fault regulations, irrespective of the receipt of the bills. In this case, the EUO of the EIP triggered the desire to perform the EUO’s of the providers. Thus, the no-fault regulations would require that the additional form of verification be within the time constraints of 65-3.5 and 65-3.8. Also, this would be consistent with established precedent: Nyack v. Gmac., 8 NY3d 294 (2007) and Keith v. Liberty, 118 A.D.2d 151 (2d Dept. 1986)
Key Takeaway
Insurance companies must request medical provider EUOs within 15 days of the injured person’s examination under oath. Untimely requests cannot toll the insurer’s obligation to pay or deny claims, leaving them vulnerable to summary judgment in favor of the healthcare provider. This strict timing requirement emphasizes the importance of coordinated investigation strategies in no-fault cases.
Related Articles
- Triable issue of fact as to non-appearance at EUO or IME
- Follow up verification issued more than 25 days too late
- Additional verification not produced is probative of nothing
- No-show failed the Alrof test for EUO non-appearance
- New York No-Fault Insurance Law
Legal Update (February 2026): The timing requirements and procedural standards for medical provider EUOs discussed in this 2013 post may have been subject to regulatory amendments or clarifications in subsequent years. Given the significance of these timing rules in no-fault practice and ongoing regulatory refinements to 11 NYCRR sections 65-3.5 and 65-3.8, practitioners should verify current provisions regarding EUO request deadlines and tolling effects before relying on the standards outlined in this analysis.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
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Apr 7, 2015Common Questions
Frequently Asked Questions
What is an Examination Under Oath (EUO) in no-fault insurance?
An EUO is a sworn, recorded interview conducted by the insurance company's attorney to investigate a no-fault claim. The insurer schedules the EUO and asks detailed questions about the accident, injuries, treatment, and the claimant's background. Under 11 NYCRR §65-3.5(e), appearing for the EUO is a condition precedent to receiving no-fault benefits — failure to appear can result in claim denial.
What happens if I miss my EUO appointment?
Missing an EUO (known as an EUO 'no-show') can result in denial of your no-fault benefits. However, insurers must follow strict procedural requirements: they must send two scheduling letters by certified and regular mail, provide adequate notice, and submit a timely denial based on the no-show. If the insurer fails to comply with these requirements, the denial can be overturned at arbitration or in court.
What questions will be asked at a no-fault EUO?
EUO questions typically cover your personal background, employment history, the circumstances of the accident, your injuries and symptoms, treatment received, prior accidents or injuries, and insurance history. The insurer's attorney may also ask about your daily activities and financial arrangements with medical providers. You have the right to have your attorney present, and your attorney can object to improper questions.
Can an insurance company require multiple EUOs for the same claim?
Yes, under 11 NYCRR §65-3.5(e), an insurer may request additional EUOs as reasonably necessary to investigate a claim. However, repeated EUO requests may be challenged as harassing or unreasonable. Courts have found that insurers cannot use EUOs as a tool to delay claims indefinitely. Each EUO request must be properly noticed with adequate time for the claimant to appear.
Do I have the right to an attorney at my EUO?
Yes. You have the right to have an attorney represent you at an EUO, and it is strongly recommended. Your attorney can prepare you for the types of questions asked, object to improper or overly broad questions, and ensure the insurer follows proper procedures. Having experienced no-fault counsel at your EUO can help protect your claim from being unfairly denied.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
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