Key Takeaway
NY court rules insurers don't need objective basis to request EUOs under No-Fault Regulation 68, making EUO requests easier to justify as reasonable.
Understanding EUO Requirements: No Objective Basis Needed
Examinations Under Oath (EUOs) are a critical tool in New York No-Fault Insurance Law that allow insurance companies to question claimants under oath about their claims. One of the ongoing debates in no-fault litigation has been whether insurers must provide an objective, factual basis when requesting an EUO from a healthcare provider or injured person.
This question is particularly important because EUOs can significantly impact claim processing timelines. When providers or claimants fail to appear for scheduled EUOs, insurers often use this as grounds to deny claims. Given the stakes involved, courts have grappled with how much justification insurers must provide when demanding these examinations.
The Metro Psychological Services case provides important clarification on this issue, reinforcing that insurers have broad discretion in requesting EUOs without needing to meet specific evidentiary thresholds beforehand.
Jason Tenenbaum’s Analysis:
Metro Psychological Servs., P.C. v 21st Century N. Am. Ins. Co., 2015 NY Slip Op 50470(U)(App. Term 2d Dept. 2015)
Again, the Court states that the failure to provide an objective basis for the performance of EUOs need not be proven to deem the request reasonable.
“Contrary to the determination of the City [*2]Court, no provision of No-Fault Regulation 68 requires an insurer to set forth any objective standards for requesting an EUO”
Key Takeaway
This ruling strengthens insurers’ position when requesting EUOs, as they don’t need to demonstrate specific red flags or suspicious circumstances to justify the examination. Healthcare providers and claimants should understand that EUO objections may be futile when based solely on the insurer’s failure to provide objective justification for the request.
