Key Takeaway
Court rules EUO request sent over 30 days after claim receipt is invalid, reinforcing strict timing requirements in New York no-fault insurance cases.
Court Reinforces Strict EUO Timing Requirements in No-Fault Cases
The timing of Examination Under Oath (EUO) requests remains a critical factor in New York no-fault insurance law. Insurance carriers must be vigilant about when they send these requests, as courts consistently enforce the 30-day rule with little tolerance for delays. A recent Appellate Term decision demonstrates how missing this deadline can completely invalidate an insurer’s defense strategy.
In no-fault insurance litigation, EUOs serve as a crucial discovery tool for insurance companies to investigate claims and potential fraud. However, these examinations must be requested within specific timeframes to be legally enforceable. When carriers fail to meet these deadlines, they risk losing their ability to deny claims based on non-compliance, even when providers genuinely fail to appear for scheduled examinations.
This timing issue has created numerous challenges for insurance companies, particularly when dealing with high-volume claims processing. The consequences of missing the 30-day window can be severe, as demonstrated in this recent case.
Jason Tenenbaum’s Analysis:
Acupuncture Now, P.C. v American Commerce Ins. Co., 2018 NY Slip Op 51768(U)(App. Term 2d Dept. 2018)
“However, plaintiff correctly argues that defendant failed to demonstrate that it was entitled to summary judgment dismissing the first cause of action based on plaintiff’s failure to appear for EUOs, as the initial EUO request had been sent more than 30 days after defendant had received the claim underlying that cause of action, and, therefore, the request was a nullity as to that claim (see Neptune Med. Care, P.C. v Ameriprise Auto & Home Ins., 48 Misc 3d 139, [*2]2015 NY Slip Op 51220 ; O & M Med., P.C. v Travelers Indem. Co., 47 Misc 3d 134, 2015 NY Slip Op 50476 ).”
Reoccurring theme.
Key Takeaway
Insurance carriers cannot rely on EUO non-compliance as grounds for claim denial when the initial EUO request was sent more than 30 days after receiving the underlying claim. Courts consistently rule such late requests are “nullities,” regardless of whether the provider actually failed to appear for the examination. This reinforces the critical importance of timely claims processing and adherence to statutory deadlines.
