Key Takeaway
Staten Island Chiropractic case reveals successful EUO investigation uncovering fee splitting violations and cooperation failures in New York no-fault insurance claims.
Staten Island Chiropractic v. American Tr. Ins. Co.
It is story time here on the blog.
I dedicate this post to the work of my former teammates at American Transit Insurance Company. It was a little more than a year ago that our team, which included James F. Sullivan, Esq., a gentleman named Yoda, a claims manager who was the Jedi Leader, a nameless team captain and myself had one of our monthly meetings in Brooklyn. At this meeting, we observed some strange billing from Staten Island Chiropractic. A decision was made to bring Staten Island Chiro for an EUO to find out what was happening. There definitely was good cause to have this EUO.
Health care counsel joined the fray and an EUO involving Mr. Sullivan, another nameless attorney and myself (in the background) materialized. The chiropractor knew he was in hot water with potential fee splitting (details that will not be put on here – you can email me if interested) and he refused to answer legitimate questions that Jim put forward. What I have since called “Park” warnings (Park v. Long Island Insurance Co. ) were issued and the chiropractor still refused to answer questions. Denials were subsequently issued based upon fee splitting and the failure to cooperate with our EUO. I still recall putting together the denial language. This whole process was surreal for so many reasons.
To my surprise, collection counsel put this into arbitration and Mr. Sullivan’s transcript spoke for itself. The denial was upheld by one of the more astute arbitrators AAA has hired in the last few years, Paul Israelson, Esq., and now the whole world can take a peek at what our brainstorming on a cold wintery day in Brooklyn at a monthly meeting engendered.
Related Articles
- Understanding EUO Requirements in New York No-Fault Insurance Cases
- When EUO counsel is not an attorney
- EUO No-Show Consequences: What Happens When You Skip Your Examination Under Oath in New York
- Understanding EUO Denial: When Insurance Companies Can Substantiate Coverage Denials
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2014 post, New York’s no-fault regulations governing examination under oath (EUO) procedures and provider cooperation requirements may have been amended. Additionally, fee schedule provisions and arbitration procedures for disputed claims could have been updated through regulatory changes or new case law developments. Practitioners should verify current EUO procedural requirements and cooperation standards under the applicable regulations.
