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EUO no-show DJ is successful (for the most part)
Declaratory Judgment Action

EUO no-show DJ is successful (for the most part)

By Jason Tenenbaum 8 min read

Key Takeaway

Second Department affirms declaratory judgment for insurer after medical provider failed to appear for two examinations under oath, establishing material breach of no-fault policy.

This article is part of our ongoing declaratory judgment action coverage, with 416 published articles analyzing declaratory judgment action issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.

IDS Prop. Cas. Ins. Co. v Stracar Med. Servs., P.C., 2014 NY Slip Op 02902 (2d Dept. 2014)

It is well established that the failure to comply with the standard policy provision requiring disclosure by way of submission to an examination under oath, as often as may be reasonably required, as a condition precedent to performance of the promise to indemnify, constitutes a material breach” of the policy, precluding recovery of the policy proceeds (Bulzomi v New York Cent. Mut. Fire Ins. Co., 92 AD2d 878, 878; see Interboro Ins. Co. v Clennon, 113 AD3d 596; Argento v Aetna Cas. & Sur. Co., 184 AD2d 487, 487-488). In support of that branch of its motion which was for summary judgment, the plaintiff, upon renewal, submitted evidence establishing “that it twice duly demanded an examination under oath” from the assignees, that the assignees twice failed to appear, and that the plaintiff “issued a timely denial of the claims” arising from the assignees’ provision of medical services to the assignors (Interboro Ins. Co. v Clennon, 113 AD3d at 597). Based upon the foregoing, the plaintiff established its prima facie entitlement to judgment as a matter of law. see id.; Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 721).

“The assignees also failed to raise a triable issue of fact as to the reasonableness or propriety of the demands for the examinations under oath”

“In light of our determination, we need not reach the plaintiff’s remaining contention.”

The Court did not cite to Unitrin, but instead cited to Fogel and Clennon.  It appears that Clennon is now the new Westchester Lincoln, except the carrier won Clennon.  The Court punted the pure Unitrin coverage issue; my hope is that whoever brings this argument has a good record with which to work.


Legal Update (February 2026): Since this 2014 decision, New York’s no-fault insurance regulations and EUO procedural requirements may have been subject to regulatory amendments or clarifications by the Department of Financial Services. Practitioners should verify current provisions regarding EUO notice requirements, compliance standards, and denial procedures under the applicable insurance law and regulations.

Legal Context

Why This Matters for Your Case

New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.

Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.

About This Topic

Declaratory Judgment Actions in Insurance Law

Declaratory judgment actions under CPLR 3001 allow insurers and claimants to obtain a judicial determination of their rights under an insurance policy before or during the course of litigation. In the no-fault context, carriers frequently seek declaratory judgments on coverage, fraud, and policy procurement issues. These articles analyze the procedural requirements, strategic considerations, and substantive standards governing declaratory judgment practice in New York insurance disputes.

416 published articles in Declaratory Judgment Action

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Common Questions

Frequently Asked Questions

What is a declaratory judgment action in insurance litigation?

A declaratory judgment action under CPLR 3001 asks the court to determine the rights and obligations of the parties under an insurance policy. In no-fault practice, insurers frequently file declaratory judgment actions to establish that they have no obligation to pay claims — for example, by seeking a declaration that the policy is void due to fraud or material misrepresentation on the application. Defendants can cross-move for summary judgment or raise counterclaims for the unpaid benefits.

What is an Examination Under Oath (EUO) in no-fault insurance?

An EUO is a sworn, recorded interview conducted by the insurance company's attorney to investigate a no-fault claim. The insurer schedules the EUO and asks detailed questions about the accident, injuries, treatment, and the claimant's background. Under 11 NYCRR §65-3.5(e), appearing for the EUO is a condition precedent to receiving no-fault benefits — failure to appear can result in claim denial.

What happens if I miss my EUO appointment?

Missing an EUO (known as an EUO 'no-show') can result in denial of your no-fault benefits. However, insurers must follow strict procedural requirements: they must send two scheduling letters by certified and regular mail, provide adequate notice, and submit a timely denial based on the no-show. If the insurer fails to comply with these requirements, the denial can be overturned at arbitration or in court.

What questions will be asked at a no-fault EUO?

EUO questions typically cover your personal background, employment history, the circumstances of the accident, your injuries and symptoms, treatment received, prior accidents or injuries, and insurance history. The insurer's attorney may also ask about your daily activities and financial arrangements with medical providers. You have the right to have your attorney present, and your attorney can object to improper questions.

Can an insurance company require multiple EUOs for the same claim?

Yes, under 11 NYCRR §65-3.5(e), an insurer may request additional EUOs as reasonably necessary to investigate a claim. However, repeated EUO requests may be challenged as harassing or unreasonable. Courts have found that insurers cannot use EUOs as a tool to delay claims indefinitely. Each EUO request must be properly noticed with adequate time for the claimant to appear.

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Attorney Jason Tenenbaum

About the Author

Jason Tenenbaum, Esq.

Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.

Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.

24+ years in practice 1,000+ appeals written 100K+ no-fault cases $100M+ recovered

Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.

New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.

If you need legal help with a declaratory judgment action matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.

Jason Tenenbaum, Personal Injury Attorney serving Long Island, Nassau County and Suffolk County

About the Author

Jason Tenenbaum

Jason Tenenbaum is a personal injury attorney serving Long Island, Nassau & Suffolk Counties, and New York City. Admitted to practice in NY, NJ, FL, TX, GA, MI, and Federal courts, Jason is one of the few attorneys who writes his own appeals and tries his own cases. Since 2002, he has authored over 2,353 articles on no-fault insurance law, personal injury, and employment law — a resource other attorneys rely on to stay current on New York appellate decisions.

Education
Syracuse University College of Law
Experience
24+ Years
Articles
2,353+ Published
Licensed In
7 States + Federal

Discussion

Comments (8)

Archived from the original blog discussion.

MH
Mike H
this essentially shuts down the curiosity/anomaly that a suit with an EUO outstanding is “premature.” Great Wall Acupuncture, P.C. v NYCM. 2009 NY Slip Op 50294(U)”Since the date selected for the EUO was reasonable and plaintiff did not appear for the scheduled EUO, defendant’s motion for summary judgment should have been granted since the action was premature.” when an insurer wants a provider EUO very little changes year to year. how is this different if documentary verification is outstanding for 10 years? if the Court is gonna go all out, go all out. if the Division is so concerned about the insurer being “entitled to obtain information promptly while the information is still fresh to enable it to decide upon its obligations and protect against false claims,” why not overturn Fair Price? Why rule that a provider doesn’t need to prove the truth of their bills- Viviane? just EUO/DJ action every claim; get rid of no-fault. Defense firms- my resume is available upon request.
KL
Kurt Lundgren
Why Mike, because No Fault like Rock and Roll is here to stay. Or I think it is anyway. I deal with too many defense attorneys in no fault who never practiced in personal injury. They just don’t get it. The insurance carriers mantra is delay, deny, defend. But in no fault there is an added bonus – the denial of treatment may curtail the injured parties ability to overcome threshold in a personal injury suit. Do away with no-fault – that opens the door for everyone who is injured in a car accident to sue. That would be bad for the insurance companies. Yesterday I spoke with an old friend who used to be a no fault attorney for a defense firm that we all know, love, and is located in Westbury. He is now a plaintiff attorney and does personal injury cases in another state. No threshold in that State … big verdicts/settlements for soft injury cases that would be squashed in NYS. So, get rid of no fault? There is no way for an insurance company to even try to contain its exposure without no fault. I am not sympathetic to insurance companies, but I do respect their plight. They can defend no fault arbs/lit but we cannot defend special damages in a BI lawsuit. No fault is the lesser of two evils. Long Live No Fault. Mike, why would you send you resume to defense firms. If no fault is eliminated, they are the first to go. Try Jacoby & Meyers instead.
J
JT Author
Kurt, In New York, the insurance carriers have a double whammy now. First, the Court of Appeals killed threshold in Perl. I mean killed it. The Third and Fourth Departments knowingly ignore the Perl rule which states that lack of contemporaneous treatment is an issue of fact as to causation; not a bar to recovery. But, the majority of the cases are in the First and Second Departments. By the way, how many threshold motions now survive appellate scrutiny? Few and far between. Now, carriers are paying out in sustained verdicts of $350,000-$1,000,000 for herniations. Second, as an added bonus, the carriers have to pay first-party no-fault benefits, which claims are difficult to defeat in arbitration. Third, the first $50,000 of treatment is lien free. Why not be a plaintiff no-fault attorney specializing in post IME services in arbitration and then grab the associated PI case? That’s what Mike H should do.
TH
The Hater
Oh yeah the carriers are getting slaughtered. Supreme Court judges slavishly follow the Court of Appeals. So do App Divisions. Slavish adherence to the law. And the insurance policies on these vehicles are all $500,000 dollar policies. They must be borrowing money faster than the United States to pay for all the stupid f*&king ads that try to sell you no fault. I want to kill that f*&king Gecco. Stomp him until he’s nothing but green slime like insurance company execs; Wrynn and the greasy haired governor. The carriers are in it for the humanity. Go take another hit off your crack pipe.
MH
Mike H
yeah, post IMEs and medical necessity are fine and happy, but my beef is with the ‘investigation’ of unrepresented medical facilities at the time the medical services are being rendered and the provider, having later retained an attorney, having no recourse if they later wish to cooperate. no-fault was not designed for this insurrection of common law fraud defense, as the majority of my time is spent on answering EUO letters and defending no show motions. Instead of having 5 police officers operating the Kings Civil elevators they should be investigating insurance fraud. SIU are well qualified to operates the lifts. “the Appellate Division, Second Department, has repeatedly warned insurers against either repudiating liability or defending on one particular ground and then, shifting gears, creating new means or defenses to avoid payment”…“if the foregoing holdings are ignored, the no-fault litigation would be treated like any other garden variety common-law litigation with a full panoply of discovery rights, turning no-fault litigation to its present condition—a Frankenstein monster that has assumed a life force of its own, becoming so unmanageable and uncontrollable that it acts out in ways never envisioned by its creator.” Metropolitan Radiological Imaging, P.C. v. State Farm Mutual Automobile Insurance Company, 2005 NY Slip Op 25063 [NYC Civ. Ct., Queens County, 2005.]
KL
kurt Lundgren
I have only one thing to say in response to you Jason. One thing and one thing only!!! HAPPY BIRTHDAY young man. Have a good one. And may all your DJs be happy ones.
N
nycoolbreez
that makes sense! lets put all the medical providers in jail for fraud, do away with no-fault, raise the bar for serious physical injury then the court’s wont be so crowded, insurance companies will lower their rates and it will be christmas every day. then all those incompetent non-literate lawyers the insurance companies employ can go do collection work. Oh that’s right collection companies are merging, looking for collection lawyers with a mutli-state footprint so that work is now drying up. Wait maybe those lawyers can do construction defense. oh that is right value billing is reducing the numbers of construction defense firms. well maybe they can do criminal defense, oh wait crime is down and 2d dep’t 18(b) is closed. wake up douches !!!!! the only paycheck most of you are capable of collecting is because of no-fault. Otherwise most of you would be sitting in a warehouse in princeton, New Jersey writing up privilege logs, if all the grads from NYU, Fordham and SJU dont get to them first. you Douches don’t even know who feeds you.
TH
The Hater
nycoolbreez That was cool and so true. Can you imagine even a big time no fault lawyer really trying a case worth millions in front of a jury. They’d make the Public Defender from My Cousin Vinny look like Clarence Darrow. And now they use terms like “have your client come in and be Queen for a day” — like their prosecutors proffering real organized crime. The Hater wants some creep provider to fight a case so he can destroy these firms I/F/O a jury where they can’t hide.

Legal Resources

Understanding New York Declaratory Judgment Action Law

New York has a unique legal landscape that affects how declaratory judgment action cases are litigated and resolved. The state's court system includes the Civil Court (for claims up to $25,000), the Supreme Court (the primary trial court for unlimited jurisdiction), the Appellate Term (which hears appeals from lower courts), the Appellate Division (divided into four Departments, with the Second Department covering Long Island, Brooklyn, Queens, Staten Island, and several upstate counties), and the Court of Appeals (the state's highest court). Each court has its own procedural requirements, local rules, and case-assignment practices that can significantly impact the outcome of your case.

For declaratory judgment action matters on Long Island, cases are typically filed in Nassau County Supreme Court (at the courthouse in Mineola) or Suffolk County Supreme Court (in Riverhead). No-fault arbitrations are heard through the American Arbitration Association, which assigns arbitrators throughout the metropolitan area. Workers' compensation claims go to the Workers' Compensation Board, with hearings at district offices across the state. Understanding which forum is appropriate for your case — and the specific procedural rules that apply — is essential for a successful outcome.

The procedural landscape in New York also includes important timing requirements that can affect your case. Most civil actions are subject to statutes of limitations ranging from one year (for intentional torts and claims against municipalities) to six years (for contract actions). Personal injury cases generally have a three-year deadline under CPLR 214(5), while medical malpractice claims must be filed within two and a half years under CPLR 214-a. No-fault insurance claims have their own regulatory deadlines, including 30-day filing requirements for applications and 45-day deadlines for provider claims. Understanding and complying with these deadlines is critical — missing a filing deadline can permanently bar your claim, regardless of how strong your case may be on the merits.

Attorney Jason Tenenbaum regularly practices in all of these venues. His office at 326 Walt Whitman Road, Suite C, Huntington Station, NY 11746, is centrally located on Long Island, providing convenient access to courts and offices throughout Nassau County, Suffolk County, and New York City. Whether you need representation in a no-fault arbitration, a personal injury trial, an employment discrimination hearing, or an appeal to the Appellate Division, the Law Office of Jason Tenenbaum, P.C. brings $24+ years of real courtroom experience to your case. If you have questions about the legal issues discussed in this article, call (516) 750-0595 for a free, no-obligation consultation.

New York's substantive law also presents distinct challenges. In motor vehicle cases, the no-fault system under Insurance Law Article 51 provides first-party benefits regardless of fault, but limits the right to sue for non-economic damages unless the plaintiff establishes a "serious injury" under one of nine statutory categories. This threshold — codified at Insurance Law Section 5102(d) — requires medical evidence showing more than a minor or subjective injury, and courts have developed detailed standards for each category. Fractures must be documented through imaging studies. Claims of permanent consequential limitation or significant limitation of use require quantified range-of-motion testing with comparison to norms. The 90/180-day category demands proof that the plaintiff was unable to perform substantially all of their usual daily activities for at least 90 of the 180 days following the accident.

In employment discrimination cases, the legal standards vary depending on whether the claim arises under state or local law. The New York State Human Rights Law employs a burden-shifting framework: the plaintiff must first establish a prima facie case by showing membership in a protected class, qualification for the position, an adverse employment action, and circumstances giving rise to an inference of discrimination. The burden then shifts to the employer to articulate a legitimate, non-discriminatory reason for its decision. If the employer meets this burden, the plaintiff must demonstrate that the stated reason is pretextual. The New York City Human Rights Law, by contrast, applies a broader standard, asking whether the plaintiff was treated less well than other employees because of a protected characteristic.

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