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EUO of a medical provider – untimely.
EUO issues

EUO of a medical provider – untimely.

By Jason Tenenbaum 2 min read

Why Trust This Analysis

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)

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“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.


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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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.

If you need legal help with a euo issues matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.

Jason Tenenbaum, Personal Injury Attorney serving Long Island, Nassau County and Suffolk County

Reviewed & Verified By

Jason Tenenbaum, Esq.

Jason Tenenbaum is a personal injury attorney serving Long Island, Nassau & Suffolk Counties, and New York City. Admitted to practice in NY, NJ, FL, TX, GA, MI, and Federal courts, Jason is one of the few attorneys who writes his own appeals and tries his own cases. Since 2002, he has authored over 2,353 articles on no-fault insurance law, personal injury, and employment law — a resource other attorneys rely on to stay current on New York appellate decisions.

Education
Syracuse University College of Law
Experience
24+ Years
Articles
2,353+ Published
Licensed In
7 States + Federal

Discussion

Comments (3)

Archived from the original blog discussion.

A
Anonymous
excellent analysis jt however, the carrier’s very right to an euo of the provider is stated in the regs in the same breath as the right to examine the claimant. that one breach is a failure to meet condition precedent and one is apparently not is legal fiction.
J
JT Author
I think the court was saying that if you are going to start seeking verification through an EUO and your investigation leads to the provider, then you have to abide by the timelines as it relates to verifications in the Keith v. Liberty sense. It is true that Unitrin stated that the carrier had to abide by the timelines for verification, but again, Unitrin dealt with scheduling follow-up IMEs within 10 days of the first default. Quality narrows the holding because now it takes away from the unfettered right to state that a breach of a condition precedent is a coverage defense. I think the case should be narrowly construed on its facts. As a practitioner, I believe the better way for the court to have reached this conclusion was to say that Defendant’s papers on their own raised an issue of fact as to whether its actions were unreasonable. A plaintiff’s showing that an EUO or IME is unreasonable is sufficient to warrant a trial on the issue. Clearly, a Defendant can raise an issue of fact through its own submissions. The problem of course is every Plaintiff now says that Quality means that every IME unitrin defense and EUO Unitrin defense is invalid unless there is evidence to show “timeliness”. Putting aside why counsel for Utica pushed this issue, there are now many red herrings floating around in the Unitrin sea.
AK
ALAN Klaus
As matter of law we don’t need Quality bc Unitrin states that the verification must be in accordance with the regs dowhen carriers ddon’t follow the Lawtthey should not be allowed to use it. I have cases where the carrier wants an euo of the provider 2 yrs after the receipt of the bill and when the provider doesn’t show tgey argue Unitrin and lose when it’s in front of a knowledgeable arbitrator and lose on appeal also. Reasonableness comes into play. Carriers want to rely on Unitrin for everything and I am happy we are seeing case law slowly dwindle that away.

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