Key Takeaway
New York court rules insurance company's EUO scheduling letters sent 70+ days after receiving bills were untimely and failed to toll payment obligations.
In New York’s no-fault insurance system, timing is everything. Insurance companies have strict deadlines for requesting Examinations Under Oath (EUOs) after receiving medical bills from healthcare providers. These procedural requirements exist to ensure prompt payment of legitimate claims while allowing insurers reasonable time to investigate potential fraud.
The 30-day rule is fundamental to New York No-Fault Insurance Law: insurers must either pay or deny claims within 30 days of receiving proper bills and documentation. If they need additional time to investigate through an EUO, they must schedule it promptly to “toll” (pause) this payment deadline. However, as this Appellate Term decision demonstrates, insurers who wait too long lose this right entirely.
This case highlights a common pitfall where insurance companies receive bills but delay scheduling required examinations beyond the permissible timeframe. Unlike IME scheduling requirements, EUO timing rules are strictly enforced, and procedural missteps can have serious consequences for insurers’ ability to contest claims.
Jason Tenenbaum’s Analysis:
Optimal Well-Being Chiropractic, P.C. v Ameriprise Auto & Home, 2013 NY Slip Op 51106(U)(App. Term 2d Dept. 2013)
“Defendant admits that it received the bills in question on January 11 and January 18, 2010, respectively. As the EUO scheduling letters were mailed on April 8, 2010, more than 70 days after the receipt of the bills, they were untimely and did not toll defendant’s time to pay or deny those bills”
Seems like a senseless appeal.
Key Takeaway
Insurance companies must schedule EUOs within a reasonable time after receiving no-fault bills to effectively toll their payment obligations. Waiting over 70 days to schedule an examination, as occurred here, renders the EUO request untimely and ineffective. This leaves insurers liable for the full amount of the submitted bills, making such delays costly procedural errors that courts will not excuse.
Legal Update (February 2026): Since this 2013 decision, New York’s no-fault regulations and procedural requirements for EUO scheduling may have been amended through regulatory updates or subsequent court decisions. Practitioners should verify current timing requirements, notice provisions, and tolling procedures under the most recent versions of 11 NYCRR Part 65 and applicable case law, as procedural deadlines and scheduling requirements are subject to periodic revision.
