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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.
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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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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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