Key Takeaway
Court rejects distinction between EUO no-shows before and after claim submission, reinforcing uniform contractual remedy standards in no-fault insurance disputes.
Understanding EUO No-Show Consequences: When Timing Doesn’t Matter
Examinations Under Oath (EUOs) represent a critical component of New York no-fault insurance law, allowing insurance carriers to investigate claims through sworn testimony. When claimants fail to appear for these examinations, insurers typically invoke contractual remedies to deny coverage. A recurring question in no-fault litigation has been whether the timing of a no-show—before or after claim form submission—should affect the available remedies.
Recent appellate decisions have addressed this timing distinction, with courts examining whether insurers should have different contractual options based on when the EUO failure occurs in the claims process. This issue has particular significance for medical providers and other no-fault claimants who face EUO obligations as part of routine claims investigations.
The resolution of timing-based distinctions has implications for how courts interpret insurance policy language and the uniformity of contractual enforcement in no-fault cases. Understanding these judicial interpretations helps practitioners navigate EUO-related disputes more effectively.
Jason Tenenbaum’s Analysis:
National Med. & Surgical Supply, Inc. v ELRAC, Inc., 2017 NY Slip Op 50028(U) (App. Term 2d Dept. 2017)
“Contrary to plaintiff’s assertion, there is no basis for a distinction between defendant’s contractual remedies when “the failure to appear for occurs before the submission of the claim form or after its submission” (id. at 722).”
This line of reasoning has its force from the Manoo debacle at the First Department.
Key Takeaway
The Second Department’s Appellate Term definitively rejected attempts to create timing-based distinctions for EUO no-show remedies. Whether a claimant fails to appear before or after submitting their claim form, insurers maintain the same contractual options for addressing non-compliance. This ruling promotes consistency in no-fault insurance enforcement and eliminates potential loopholes that could undermine the EUO process.
