Key Takeaway
Court rules Allstate failed to prove proper mailing of EUO scheduling letters, highlighting critical procedural requirements in no-fault insurance disputes.
Allstate’s Procedural Misstep: When Proof of Mailing Matters
Examination Under Oath (EUO) proceedings are a cornerstone of no-fault insurance defense strategies, allowing insurers to investigate claims and potentially deny benefits for non-compliance. However, insurers must follow strict procedural requirements when scheduling these examinations. A recent Appellate Term decision demonstrates how seemingly minor oversights in documentation can completely undermine an insurer’s defense.
The case of Great Health Care Chiropractic, P.C. v Allstate Insurance Co. illustrates a fundamental principle: insurers cannot simply claim they properly scheduled an EUO—they must prove it. This burden of proof extends beyond showing that letters were sent; insurers must demonstrate proper and timely mailing procedures were followed.
Jason Tenenbaum’s Analysis:
Great Health Care Chiropractic, P.C. v Allstate Ins. Co., 2016 NY Slip Op 50311(U)(App. Term 2d Dept. 2016)
“In support of its motion, defendant failed to establish that the initial and follow-up EUO scheduling letters had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ). As a result, defendant failed to demonstrate that the EUOs had been properly scheduled and, thus, that plaintiff’s assignor had failed to appear at duly scheduled EUOs”
I am curious if this was a violation of the 10-day rule or just lack of proof of mailing?
Key Takeaway
This decision reinforces that insurers cannot rely on EUO no-show defenses without proper documentation of timely mailing. Whether the issue was a 10-day rule violation or insufficient proof of mailing, the result remains the same: Allstate’s defense failed due to inadequate procedural compliance, demonstrating why meticulous record-keeping is essential in no-fault insurance disputes.
