Key Takeaway
Learn why EUO no-shows occur when insurers fail to provide required justification. Court rules insurers must give specific objective reasons for EUO requests.
This article is part of our ongoing euo issues coverage, with 197 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.
Avalon Radiology, PC. v Ameriprise Ins. Co., 2016 NY Slip Op 26182 (Dis. Ct. Suffolk Co. 2016)
“Avalon responded to the first EUO request with a letter dated April 3, 2014, requesting the good faith, objective reason for defendant’s request for an EUO pertaining to Avalon’s incorporation and licensure, as well as the basis for suspecting it had engaged in fraudulent behavior (Exhibit K). In response to Avalon’s letter of April 3, 2014, defendant sent a second letter dated April 14, 2014, stating that it was not required to provide the specific objective justification for its EUO request and rescheduling the EUO for May 1, 2014 (Exhibit L), as well as a third letter dated April 18, 2014, also setting forth the May 1, 2014 EUO date (Exhibit H). The claims were denied following Avalon’s failure to appear for the May 1, 2014 EUO (Exhibits R, S and T).”
“The insurer’s response in this case to the effect that it was not obligated to do so is plainly wrong. The insurer clearly had an obligation to comply with No-Fault regulation 65-3.5(e)and supply the requesting party, in this case the provider, with the “specific objective justification supporting the use of such examination.” The regulations do not allow the insurer to use an EUO as a fishing expedition. There must be a specific objective reason for the request. See American Transit v Jaga Medical Services, P.C., 128 AD3d 441 (1st Dep’t 2015); American Transit v Curry, 45 Misc 3d 171 (Sup.Ct. NY Co. 2013). If the Court were to conclude otherwise, the cited language of the applicable regulation would be rendered meaningless.”
I have to agree with the District Court on this one. To dictate letters to providers demanding a provider’s appearances at EUOs without giving a reason when asked to provide a reason is improper. That is plain and simple. When taken to the mat as to why an EUO is necessary, the carrier must respond. The Court got this one right. Hopefully EUO counsel has learned from their mistakes.
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Legal Update (February 2026): Since this 2016 post was published, No-Fault Regulation 65-3.5 governing examination under oath procedures may have been amended, including potential changes to disclosure requirements for EUO justifications and procedural timelines. Additionally, subsequent court decisions may have further clarified insurers’ obligations to provide specific objective reasons for EUO requests. Practitioners should verify current regulatory provisions and recent case law developments when advising on EUO compliance issues.
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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Oct 22, 2019Was this article helpful?
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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