Key Takeaway
Court rules EUO denial valid despite not specifying examination dates, rejecting plaintiff's argument that omission made denial vague or conclusory under New York no-fault law.
This article is part of our ongoing euo issues coverage, with 217 published articles analyzing euo issues 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.
Court Upholds EUO Denial Despite Missing Examination Dates
Insurance carriers often deny no-fault claims when assignors fail to appear for scheduled examinations under oath (EUOs). A common challenge from healthcare providers is that denial forms are defective if they don’t include specific details like examination dates. However, a recent Appellate Term decision clarifies that such omissions don’t automatically invalidate an otherwise proper denial.
In the context of New York No-Fault Insurance Law, EUO requirements serve as crucial tools for carriers to investigate claims. When assignors fail to appear for these examinations, carriers can legitimately deny coverage. The question often becomes whether the denial itself meets legal standards for specificity.
This case addresses a frequent dispute in no-fault litigation: how detailed must denial forms be to satisfy legal requirements? While some providers argue that missing dates render denials fatally defective, courts have shown they’re willing to uphold denials that clearly state the reason for denial, even without every specific detail.
Jason Tenenbaum’s Analysis:
Quality Psychological Servs., P.C. v Avis Rent-A-Car Sys., LLC, 2015 NY Slip Op 50378(U)(App. Term 2d Dept. 2015)
“Here, plaintiff has not alleged that it did not receive a denial of claim from defendant. Moreover, the denial of claim form attached to defendant’s motion papers, which plaintiff argues is fatally defective, states that the claim was being denied because plaintiff’s assignor had failed to appear for two properly scheduled examinations under oath. Contrary to plaintiff’s argument, the failure to set forth the dates of the scheduled examinations in the denial of claim form did not render the denial conclusory, vague, or without merit as a matter of law”
The denial was valid despite not setting forth the date on the denials.
Key Takeaway
Courts will uphold EUO-based claim denials even when specific examination dates aren’t listed in the denial form. As long as the denial clearly states that the assignor failed to appear for properly scheduled examinations under oath, the omission of dates doesn’t render the denial legally defective. This ruling provides carriers with flexibility in their denial language while maintaining the substance of their defense. Healthcare providers challenging such denials based solely on missing dates may find their arguments unsuccessful, particularly when dealing with EUO no-show scenarios or multiple examination failures.
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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.
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May 22, 2021Proof of no-show?
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Dec 26, 2017Additional verification not produced is probative of nothing
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Oct 6, 2015Understanding EUO Denial: When Insurance Companies Can Substantiate Coverage Denials
Learn when insurance companies can deny coverage for EUO non-compliance. Expert legal guidance on examination under oath requirements in NY. Call 516-750-0595.
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Jul 20, 2010Common Questions
Frequently Asked Questions
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.
Do I have the right to an attorney at my EUO?
Yes. You have the right to have an attorney represent you at an EUO, and it is strongly recommended. Your attorney can prepare you for the types of questions asked, object to improper or overly broad questions, and ensure the insurer follows proper procedures. Having experienced no-fault counsel at your EUO can help protect your claim from being unfairly denied.
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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.
If you need legal help with a euo issues 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.