Key Takeaway
Court rules insurance companies don't need to produce policy documents to establish EUO provisions when accident occurred after 2002 mandatory endorsement.
Understanding EUO Requirements in No-Fault Insurance Cases
When insurance companies request examinations under oath (EUOs) to investigate claims, healthcare providers sometimes challenge whether the insurer has the contractual right to demand such examinations. A common defense strategy involves arguing that the insurance company must produce the actual policy language to prove EUO provisions exist.
However, New York courts have established clear precedent that makes this argument largely futile for accidents occurring after April 2002. The Appellate Term’s decision in Dream Acupuncture demonstrates how regulatory changes simplified this evidentiary burden for insurers, particularly in New York No-Fault Insurance Law cases.
This ruling has significant implications for providers facing EUO demands, as it eliminates one potential procedural defense and underscores the importance of understanding when EUO objections may be futile versus when substantive challenges might succeed.
Jason Tenenbaum’s Analysis:
Dream Acupuncture, P.C. v State Farm Fire & Cas. Co., 2013 NY Slip Op 51997(U)(App. Term 2d Dept 2013)
“Contrary to plaintiff’s other argument on appeal, it was not defendant’s burden to demonstrate that the applicable policy condition contains a provision for using EUOs as a method of verifying claims. As we have previously noted, effective April 5, 2002, the mandatory personal injury endorsement contains a provision for EUOs (see Insurance Department Regulations § 65-1.1 ). The accident in question occurred on February 9, 2007. Since the policy in this case would have been issued after 2002, it would necessarily have contained a provision for EUOs, and, thus, defendant was not required to produce the policy to establish the existence of such a provision”
Yes, this is old already.
Key Takeaway
For any accident occurring after April 5, 2002, insurance companies are not required to produce policy documents to establish their right to conduct EUOs. The mandatory personal injury endorsement regulation ensures all policies issued after this date automatically contain EUO provisions, making policy production arguments ineffective in most modern no-fault cases.
Legal Update (February 2026): Since this 2013 post, New York’s no-fault insurance regulations have undergone multiple amendments, including potential changes to EUO procedures, standardized policy provisions, and evidentiary requirements under Insurance Department Regulations § 65. Practitioners should verify current regulatory provisions and recent case law developments, as procedural requirements for EUO motions and policy disclosure obligations may have been modified through subsequent regulatory updates or appellate decisions.
