Alrof again…

Understanding Examination Under Oath Requirements in No-Fault Insurance Cases

The intersection of New York No-Fault Insurance Law and examination under oath (EUO) procedures continues to generate significant litigation. When insurance companies seek to deny claims based on a claimant’s failure to appear for scheduled examinations, courts must carefully evaluate whether proper procedures were followed by all parties.

The Alrof decision has become a cornerstone in EUO jurisprudence, establishing critical precedents about when an insurance company can successfully defend against no-fault claims based on examination failures. This particular case demonstrates the courts’ reluctance to grant summary judgment when EUO objections may be futile or when proper scheduling procedures haven’t been clearly established.

Understanding these dynamics is crucial for both healthcare providers seeking payment and insurance companies defending claims. The burden of proof regarding proper EUO scheduling and the consequences of non-appearance requires careful documentation and adherence to procedural requirements.

Jason Tenenbaum’s Analysis:

EMC Health Prods., Inc. v Travelers Ins. Co., 2015 NY Slip Op 50475(U)(App. Term 2d Dept. 2015)

Another Alrof sighting…

“Consequently, plaintiff’s motion for summary judgment was properly denied. However, defendant’s cross motion should also have been denied, as defendant failed to establish, as a matter of law, its defense that plaintiff had failed to appear for properly scheduled examinations under oath”

Key Takeaway

This decision reinforces that insurance companies cannot simply claim EUO non-appearance as a defense without proving proper scheduling procedures were followed. The court’s denial of both summary judgment motions reflects the fact-intensive nature of EUO no-show cases and emphasizes that procedural compliance must be clearly demonstrated rather than assumed.