Key Takeaway
Court ruling establishes that healthcare providers who fail to respond to EUO requests cannot later raise objections, reinforcing insurer notification requirements.
Understanding EUO Requirements: When Provider No-Shows Waive Objection Rights
Examination Under Oath (EUO) proceedings are a critical component of New York No-Fault Insurance Law, serving as an investigative tool for insurance companies to verify claims. When healthcare providers receive EUO scheduling letters, their response—or lack thereof—can significantly impact their ability to challenge the insurer’s actions later in litigation.
The Flatbush Chiropractic case presents a clear example of how courts handle situations where providers completely ignore EUO requests. This ruling reinforces established legal principles about waiver of objections and proper notice requirements in no-fault insurance disputes. For healthcare providers, understanding these requirements is essential to preserving their rights in claim disputes.
Jason Tenenbaum’s Analysis:
Flatbush Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co., 2013 NY Slip Op 50758(U)(App. Term 2d Dept. 2013)
“Contrary to plaintiff’s argument, the affidavits submitted by defendant established that the EUO scheduling letters and the denial of claim forms had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 ). Furthermore, since plaintiff does not claim to have responded in any way to the EUO requests, its [*2]objections regarding the EUO requests will not now be heard (see Viviane Etienne Med. Care, P.C. v State Farm Mut. Auto. Ins. Co., 35 Misc 3d 127, 2012 NY Slip Op 50579 ; Crescent Radiology, PLLC v American Tr. Ins. Co., 31 Misc 3d 134, 2011 NY Slip Op 50622 ).”
This is a condensed statement of fact and law on the EUO provider no-show front.
Key Takeaway
This decision establishes two crucial principles: insurance companies must properly document timely mailing of EUO notices, but healthcare providers who fail to respond to EUO requests forfeit their right to raise objections later. As demonstrated in similar cases involving EUO no-shows, complete non-response creates an insurmountable procedural hurdle for providers seeking to challenge denials in court.
Legal Update (February 2026): Since this post’s publication in 2013, New York’s no-fault insurance regulations have undergone several amendments, including potential changes to EUO notice requirements, timing provisions, and waiver standards under 11 NYCRR Part 65. Additionally, subsequent court decisions may have refined or modified the legal principles regarding provider objection rights and procedural compliance discussed in the Flatbush Chiropractic analysis. Practitioners should verify current regulatory provisions and recent case law developments when advising on EUO compliance matters.
