Key Takeaway
EUO no show sustained - Court grants summary judgment against medical provider when assignor failed to appear for scheduled Examination Under Oath in NY no-fault case.
This article is part of our ongoing declaratory judgments coverage, with 233 published articles analyzing declaratory judgments 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.
American Tr. Ins. Co. v Cartagena, 2014 NY Slip Op 31696(U)(Sup. Ct. NY Co. 2014)
“Plaintiff AMERICAN TRANSIT INSURANCE COMPANY in this declaratory judgment action moves for a summary judgment for the relief demanded in the Complaint pursuant to CPLR 3212 in its favor against defendant LONGEVITY MEDICAL SUPPLY, INC. based upon the failure to provide duly scheduled “Examinations Under Oath” of defendant assignor REMANSIA CARTAGENA, an individual who
assigned to defendant LONGEVITY MEDICAL SUPPLY, INC., a medical/health care provider, his/her right to be reimbursed for benefits under the No-Fault law~ for the expenses of treatment for injuries suffered in an automobile accident on November 20, 2011.
As held by the First Department in Unitrin Advantage Ins Co v Bayshore Physical Therapy, 82 AD3d 559, 560 (1st Dept 2011): The failure to appear for requested by the insurer ” … as … may reasonably require” (Insurance Department Regulations § 65-1.1) is a breach of a condition precedent to coverage under the no-fault policy, and therefore fits squarely within the exception to the preclusion doctrine, as set forth in Central Gen. Hosp. v Chubb Group of Ins. Cos. ( 90 NY2d 195 · ) .
As in Unitrin, here “plaintiff has satisfied its prima facie burden on summary judgment of establishing that it requested (EUOs) in accordance with the procedures and time frames set forth in the no-fault implementing regulations, and that defendants’ assignors did not appear. In opposition, defendants failed to raise an issue of fact that the requests were unreasonable”. “The affidavit of service raised a presumption that a·proper mailing occurred, which defendants failed to rebut” (American Transit Insurance Company v Marte-Rosario, 11 AD3d 442 ) . Finally, Cambridge Medical, P.C. v Progressive Casualty Ins. Co., 29 Misc3d 186 (NYC Civil Co, Richmond Co 2010), an opinion of coordinate jurisdiction not binding on this court, stands only for the proposition that under 11 NYCRR 65-3.6, the insurer may send the notice for follow up verification to the insurer, as assignee, and is not required to so notice the injured party. In addition, Cambridge interprets a rule separate from 11 NYCRR 65-1.1 with respect to Examinations Under Oath (EUO), the rule at issue here”
The Defendant walked into oral argument according to my report with a case called Cambridge v. Progressive and said that our Dec action was invalid. I barely recalled Judge Levine’s case as she writes so many. I look it up and told my attorney if the judge was considering this act of desperation. He laughed. I am glad the judge realized this was smoke in mirrors.
Related Articles
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- Understanding New York No-Fault Insurance EUO Requirements: Why DFS Does Not Approve Improper Disclaimers
- How to Challenge EUO No-Show Denials: When Improper Notice Can Reverse Insurance Denials in New York
- Understanding EUO Requirements in New York No-Fault Insurance Cases
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2014 decision, the no-fault regulations under 11 NYCRR Part 65 have undergone revisions, and practitioners should verify current provisions regarding EUO procedures, notice requirements, and timing deadlines. Additionally, case law developments may have further refined the application of the preclusion doctrine in EUO non-appearance cases.
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 Practice in New York
Declaratory judgment proceedings provide a mechanism for parties to obtain binding judicial determinations of their legal rights and obligations. In insurance litigation, declaratory judgments are commonly sought to resolve disputes over policy coverage, fraud allegations, and the enforceability of policy conditions. These articles analyze declaratory judgment procedure, the standards courts apply, and the strategic implications of seeking or defending against declaratory relief in New York insurance cases.
233 published articles in Declaratory Judgments
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Jan 14, 2010Proof of no-show?
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Palafox PT v State Farm case analysis on EUO justification requirements under Clennon precedent, showing insurers need only prove dual demands and failures to appear.
Nov 28, 2015Alrof citing again – never a good thing
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Apr 19, 2014Common Questions
Frequently Asked Questions
What is a declaratory judgment action in no-fault insurance?
A declaratory judgment action is a lawsuit asking the court to determine the rights and obligations of the parties — typically whether an insurer has a duty to pay no-fault benefits. Insurers often file these actions to establish they have no obligation to pay, citing policy exclusions, fraud, or coverage disputes.
When do insurers file declaratory judgment actions?
Insurers commonly file declaratory judgment actions when they believe a policy is void due to material misrepresentation, the loss was intentional, or there is a coverage dispute. Under NY Insurance Law, the insurer must demonstrate a justiciable controversy and typically seeks a declaration that it has no duty to indemnify or defend.
How does a declaratory judgment affect my no-fault benefits?
If the court rules in the insurer's favor, your no-fault benefits may be terminated. However, if the insurer fails to meet its burden of proof or did not timely commence the action, the court may rule in your favor, requiring the insurer to continue paying benefits. Having experienced counsel is critical in these proceedings.
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.
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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.
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.
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