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EUO & IME no show
Additional Verification

EUO & IME no show

By Jason Tenenbaum 8 min read

Key Takeaway

Court denies plaintiff's motion in no-fault case due to failed verification compliance and assignor's failure to appear for required IMEs and EUOs.

This article is part of our ongoing additional verification coverage, with 403 published articles analyzing additional verification 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.

Compas Med., P.C. v Praetorian Ins. Co., 2015 NY Slip Op 51467(U)(App. Term 2d Dept. 2015)

“The Civil Court denied plaintiff’s motion, granted the branch of defendant’s cross motion seeking summary judgment dismissing plaintiff’s third cause of action as premature because plaintiff had failed to provide requested verification, and granted the branches of defendant’s cross motion seeking summary judgment dismissing the remaining causes of action due to the failure of plaintiff’s assignor to appear for independent medical examinations (IMEs) and examinations under oath (EUOs).

In support of the branch of defendant’s cross motion seeking summary judgment dismissing plaintiff’s third cause of action, defendant submitted an affidavit by its claims examiner which established that defendant had timely mailed its verification request and follow-up verification request (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 ). Defendant demonstrated prima facie that it had not received the requested verification and thus that plaintiff’s third cause of action is premature (see 11 NYCRR 65-3.8 ; Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492 ). As plaintiff failed to raise a triable issue of fact, the Civil Court properly granted the branch of defendant’s cross motion seeking summary judgment dismissing this cause of action.”

My case.  Thank you.  On this one, there was no affidavit attempting to explain the verification compliance.

The Compas Medical decision illustrates a critical strategic reality in no-fault litigation: carriers need prevail on only one defense to defeat a provider’s claim. Praetorian Insurance asserted three separate defenses—verification non-compliance, IME no-shows, and EUO no-shows. The court addressed the verification defense first, finding it dispositive of one cause of action, then addressed the examination no-shows separately for remaining causes of action.

This layered defense strategy creates significant challenges for providers. Even if a provider could overcome the verification defense, it still must defeat both the IME and EUO no-show defenses. Each defense requires different proof and raises distinct legal issues. Verification involves documentary evidence of what was requested and what was provided. IME no-shows require proof of proper notice, reasonably convenient scheduling, and actual non-appearance. EUO no-shows similarly demand evidence of proper notice and non-appearance. For providers to prevail, they must successfully refute every procedural defense the carrier asserts. One failure dooms the entire case. This asymmetry favors insurers, who can assert multiple defenses knowing that success on any single defense achieves their litigation objective.

Practical Implications for Healthcare Providers

The Compas Medical decision underscores the importance of meticulous compliance with all no-fault procedural requirements. Providers cannot afford to ignore verification requests while focusing on examination appearances, or vice versa. Every procedural demand from the carrier must be addressed comprehensively and documented carefully. When providers receive verification requests, they should respond completely and retain proof of their responses. When examination notices arrive, providers must ensure claimants appear or have documented excuses for non-appearance. The failure to comply with any single requirement can result in dismissal regardless of how strong the provider’s substantive case may be. This case also demonstrates why carriers often prefer multiple procedural defenses over substantive medical necessity challenges. Procedural defenses are often easier to prove, requiring only evidence of requests and non-compliance rather than expert medical testimony about treatment appropriateness.


Legal Update (February 2026): Since this 2015 post, 11 NYCRR 65-3 has undergone several amendments affecting verification requirements, EUO procedures, and IME scheduling protocols. Practitioners should verify current provisions regarding notice requirements, timeframes for compliance, and procedural safeguards, as regulatory changes may have modified the standards applied in no-show determinations.

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.

About This Topic

Additional Verification in No-Fault Claims

Under New York's no-fault regulations, insurers may request additional verification of a claim within specified time limits. The timeliness, scope, and reasonableness of verification requests — and the consequences of a claimant's failure to respond — are among the most litigated issues in no-fault practice. These articles examine the regulatory framework for verification requests, court decisions on compliance, and the interplay between verification delays and claim determination deadlines.

403 published articles in Additional Verification

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Common Questions

Frequently Asked Questions

What is additional verification in no-fault insurance?

Additional verification is a request by the insurer for more information to process a no-fault claim, authorized under 11 NYCRR §65-3.5. When the insurer sends a verification request, the 30-day clock for claim processing is tolled (paused) until the requested information is received. This is a common insurer tactic to delay payment — but the verification request must be timely and relevant to be valid.

How long does an insurer have to request additional verification?

Under the no-fault regulations, the insurer must request initial verification within 15 business days of receiving the claim. Follow-up verification requests must be made within 10 business days of receiving a response to the prior request. If the insurer fails to meet these deadlines, the verification request is invalid and cannot be used to toll the claim processing period.

What types of additional verification can a no-fault insurer request?

Under 11 NYCRR §65-3.5, insurers may request medical records, provider licensing documentation, proof of treatment rendered, tax returns or financial records (in certain fraud investigations), authorization for release of medical records, and signed NF-3 verification forms. The verification request must be relevant to the claim and not overly burdensome. Requests for information not reasonably related to claim processing may be challenged as improper.

What happens if I don't respond to a no-fault verification request?

Failure to respond to a timely and proper verification request can result in denial of your no-fault claim. Under 11 NYCRR §65-3.5(o), if the requested verification is not provided within 120 calendar days of the initial request, the claim is deemed denied. The 120-day period runs from the date of the original request. However, if the verification request itself was untimely or improper, the denial based on non-response may be challenged.

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.

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Attorney Jason Tenenbaum

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.

24+ years in practice 1,000+ appeals written 100K+ no-fault cases $100M+ recovered

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 additional verification 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.

Jason Tenenbaum, Personal Injury Attorney serving Long Island, Nassau County and Suffolk County

About the Author

Jason Tenenbaum

Jason Tenenbaum is a personal injury attorney serving Long Island, Nassau & Suffolk Counties, and New York City. Admitted to practice in NY, NJ, FL, TX, GA, MI, and Federal courts, Jason is one of the few attorneys who writes his own appeals and tries his own cases. Since 2002, he has authored over 2,353 articles on no-fault insurance law, personal injury, and employment law — a resource other attorneys rely on to stay current on New York appellate decisions.

Education
Syracuse University College of Law
Experience
24+ Years
Articles
2,353+ Published
Licensed In
7 States + Federal

Legal Resources

Understanding New York Additional Verification Law

New York has a unique legal landscape that affects how additional verification cases are litigated and resolved. The state's court system includes the Civil Court (for claims up to $25,000), the Supreme Court (the primary trial court for unlimited jurisdiction), the Appellate Term (which hears appeals from lower courts), the Appellate Division (divided into four Departments, with the Second Department covering Long Island, Brooklyn, Queens, Staten Island, and several upstate counties), and the Court of Appeals (the state's highest court). Each court has its own procedural requirements, local rules, and case-assignment practices that can significantly impact the outcome of your case.

For additional verification matters on Long Island, cases are typically filed in Nassau County Supreme Court (at the courthouse in Mineola) or Suffolk County Supreme Court (in Riverhead). No-fault arbitrations are heard through the American Arbitration Association, which assigns arbitrators throughout the metropolitan area. Workers' compensation claims go to the Workers' Compensation Board, with hearings at district offices across the state. Understanding which forum is appropriate for your case — and the specific procedural rules that apply — is essential for a successful outcome.

The procedural landscape in New York also includes important timing requirements that can affect your case. Most civil actions are subject to statutes of limitations ranging from one year (for intentional torts and claims against municipalities) to six years (for contract actions). Personal injury cases generally have a three-year deadline under CPLR 214(5), while medical malpractice claims must be filed within two and a half years under CPLR 214-a. No-fault insurance claims have their own regulatory deadlines, including 30-day filing requirements for applications and 45-day deadlines for provider claims. Understanding and complying with these deadlines is critical — missing a filing deadline can permanently bar your claim, regardless of how strong your case may be on the merits.

Attorney Jason Tenenbaum regularly practices in all of these venues. His office at 326 Walt Whitman Road, Suite C, Huntington Station, NY 11746, is centrally located on Long Island, providing convenient access to courts and offices throughout Nassau County, Suffolk County, and New York City. Whether you need representation in a no-fault arbitration, a personal injury trial, an employment discrimination hearing, or an appeal to the Appellate Division, the Law Office of Jason Tenenbaum, P.C. brings $24+ years of real courtroom experience to your case. If you have questions about the legal issues discussed in this article, call (516) 750-0595 for a free, no-obligation consultation.

New York's substantive law also presents distinct challenges. In motor vehicle cases, the no-fault system under Insurance Law Article 51 provides first-party benefits regardless of fault, but limits the right to sue for non-economic damages unless the plaintiff establishes a "serious injury" under one of nine statutory categories. This threshold — codified at Insurance Law Section 5102(d) — requires medical evidence showing more than a minor or subjective injury, and courts have developed detailed standards for each category. Fractures must be documented through imaging studies. Claims of permanent consequential limitation or significant limitation of use require quantified range-of-motion testing with comparison to norms. The 90/180-day category demands proof that the plaintiff was unable to perform substantially all of their usual daily activities for at least 90 of the 180 days following the accident.

In employment discrimination cases, the legal standards vary depending on whether the claim arises under state or local law. The New York State Human Rights Law employs a burden-shifting framework: the plaintiff must first establish a prima facie case by showing membership in a protected class, qualification for the position, an adverse employment action, and circumstances giving rise to an inference of discrimination. The burden then shifts to the employer to articulate a legitimate, non-discriminatory reason for its decision. If the employer meets this burden, the plaintiff must demonstrate that the stated reason is pretextual. The New York City Human Rights Law, by contrast, applies a broader standard, asking whether the plaintiff was treated less well than other employees because of a protected characteristic.

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