Key Takeaway
New York court rules that open pre-IME claims prevent insured from using repudiation defense when failing to appear for EUO after negative medical exam.
Court Rules Open Claims Prevent Repudiation Defense in EUO Case
In New York No-Fault Insurance Law, the relationship between Independent Medical Examinations (IMEs) and Examinations Under Oath (EUOs) can be complex. A recent New York Supreme Court decision clarifies an important principle: when an insurance company has pending claims that predate a negative IME, the insured cannot use the Domotor repudiation defense to avoid appearing for a subsequent EUO.
The Domotor doctrine generally provides that once an insurer denies coverage through a negative IME, it cannot later compel the insured to cooperate with policy conditions like EUOs. However, this case demonstrates a crucial exception. When there are open claims from before the IME that require “further verification,” the insurer maintains its right to demand compliance with policy terms, including EUO appearances.
Jason Tenenbaum’s Analysis:
Mapfre Ins. Co. of N.Y. v McKnight , 2013 NY Slip Op 31297(U)(Sup. Ct. NY Co.)(Edmead, J.)
I cannot copy and paste the pdf on this one but you should read it. The gist of this case is that a declaration of non coverage was granted due to Claimant’s failure to appear for an EUO subsequent to a negative IME, since there were Pre-IME claims that were delayed pending further verification, thus negating the Domotor argument. Therefore, the negative IME did not act as a bar to compel Claimant to cooperate with the terms and conditions of the insurance policy regarding his appearances at EUOs.
Key Takeaway
This decision reinforces that no-fault insurers can maintain leverage over insureds even after negative IMEs when pre-existing claims remain open. The presence of unresolved claims from before the IME preserves the insurer’s contractual rights and prevents insureds from claiming the carrier has repudiated coverage through the negative medical examination.
Legal Update (February 2026): Since this 2013 decision, New York’s no-fault insurance regulations and procedural requirements for EUOs may have been modified through regulatory amendments or updated court interpretations of the Domotor doctrine. Practitioners should verify current provisions regarding the interplay between negative IMEs, open pre-existing claims, and EUO obligations under contemporary no-fault law.
