Key Takeaway
New York appellate court reinforces Alrof precedent requiring personal knowledge proof for EUO non-appearance claims in no-fault insurance litigation.
In New York no-fault insurance litigation, one of the most contentious battlegrounds involves Examinations Under Oath (EUOs) and the procedural requirements surrounding them. Insurance companies frequently attempt to deny claims based on an insured’s alleged failure to appear for scheduled EUOs, but the courts have established strict evidentiary standards that must be met to successfully pursue such denials.
The Appellate Term’s decision in Clove Medical Supply represents another application of the important precedent established in Alrof, Inc. v Safeco National Insurance Co. This precedent requires insurance companies to provide testimony from someone with personal knowledge when claiming that a healthcare provider failed to appear for an EUO. The requirement isn’t merely procedural formality — it’s a substantive protection ensuring that EUO-related denials are based on reliable evidence rather than hearsay or assumptions.
For healthcare providers navigating New York no-fault insurance law, understanding these evidentiary requirements is crucial for challenging improper claim denials and ensuring fair treatment in the reimbursement process.
Jason Tenenbaum’s Analysis:
Clove Med. Supply, Inc. v IDS Prop. Cas. Ins. Co., 2015 NY Slip Op 51401(U)(App. Term 2d Dept. 2015)
“Because defendant failed to submit proof by someone with personal knowledge of the nonappearance of plaintiff for the EUOs in question, defendant’s motion was properly denied” Alrof, Inc. v Safeco Natl. Ins. Co., 39 Misc 3d 130, 2013 NY Slip Op 50458 ; Bright Med. Supply Co. v IDS Prop. & Cas. Ins. Co.,”
Oh Mr. IDS, your counsel did it to you again.
Key Takeaway
This decision reinforces that insurance companies cannot simply assert that a healthcare provider failed to appear for an EUO without proper evidentiary support. The Alrof standard demands testimony from someone with actual, personal knowledge of the non-appearance — not secondhand information or corporate records alone. This protective standard helps prevent frivolous denials and ensures due process in no-fault proceedings.
Common Questions
Frequently Asked Questions
What is New York's no-fault insurance system?
New York's no-fault insurance system requires all drivers to carry Personal Injury Protection (PIP) coverage. This pays for medical expenses and lost wages regardless of who caused the accident, up to policy limits. However, you can only sue for additional damages if you meet the 'serious injury' threshold.
