Key Takeaway
Court reinforces proper procedures for proving EUO no-shows in no-fault insurance cases, citing established precedent on certified transcripts and mailing requirements.
Court Reinforces Standards for Proving EUO No-Shows
The Second Department’s decision in AVM Chiropractic, P.C. v 21st Century Ins. Co. provides another solid precedent for insurance carriers defending against claims where the insured failed to appear for an Examination Under Oath (EUO). This case is particularly significant because it demonstrates how courts continue to uphold established procedures for proving both proper notice and actual non-appearance.
EUOs are a critical component of New York No-Fault Insurance Law, allowing insurers to examine insureds under oath when investigating potentially fraudulent claims. When an insured fails to appear, carriers must follow specific procedures to substantiate the no-show and preserve their right to deny coverage. The standards established in cases like this one help clarify what evidence courts will accept as sufficient proof.
Jason Tenenbaum’s Analysis:
AVM Chiropractic, P.C. v 21st Century Ins. Co., 2016 NY Slip Op 51354(U)(App, Term 2d Dept. 2016)
“Contrary to plaintiff’s only arguments on appeal, the proof submitted by defendant in support of its motion was sufficient to give rise to a presumption that the denial of claim forms at issue had been properly mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ; Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679 ), and to demonstrate that plaintiff’s assignor had failed to appear for the EUOs (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 ; Active Chiropractic, P.C. v Praetorian Ins. Co., 43 Misc 3d 134, 2014 NY Slip Op 50634 ).”
I like this case because it cites the Active Chiro case which discussed certified transcripts of no-show. That issue played out at the First Department in Liberty v. KO
Key Takeaway
This decision reinforces that insurance carriers can successfully defend EUO no-show cases by following established procedures. The court’s citation to Active Chiropractic highlights the importance of certified transcripts in proving non-appearance, while also confirming that proper mailing procedures create sufficient presumptions for coverage denials. This aligns with other recent precedents like those discussed in Allstate EUO no-show cases.
