Key Takeaway
Court rules insurance companies don't need objective reasons to request EUOs, only proper notice and proof of non-appearance for claim denial.
Understanding EUO Requirements: No Need for Objective Justification
When insurance companies request Examinations Under Oath (EUOs) in no-fault insurance cases, a common misconception persists that they must provide objective, specific reasons for making such requests. A recent appellate decision clarifies this misunderstanding and reinforces the established legal standard.
In New York No-Fault Insurance Law, EUOs serve as a crucial tool for insurers to investigate potentially fraudulent or questionable claims. The examination allows insurance companies to question claimants under oath about the circumstances surrounding their claims. However, the procedural requirements for requesting and enforcing EUOs have been the subject of ongoing litigation.
The legal landscape surrounding EUO no-shows and discovery waivers demonstrates how courts consistently prioritize procedural compliance over subjective reasoning. This approach reflects the court system’s emphasis on clear, mechanical standards rather than case-by-case evaluations of an insurer’s motivations.
Jason Tenenbaum’s Analysis:
Gentlecare Ambulatory Anesthesia Servs.; Lyonel F. Paul, M.D. v GEICO Ins. Co., 2018 NY Slip Op 51773(U)(App. Term 2d Dept. 2018)
“Furthermore, defendant was not required to set forth objective reasons for requesting EUOs in order to establish its prima facie entitlement to summary judgment, as an insurer need only demonstrate “as a matter of law that it twice duly demanded an from the … that the twice failed to appear, and that the issued a timely denial of the claim[]” (Interboro Ins. Co. v Clennon, [*2]113 AD3d 596, 597 ”
Objective reasons? Non-sense.
Key Takeaway
Courts continue to reject arguments that insurance companies must justify their EUO requests with objective reasoning. The established three-part test remains straightforward: proper demand, documented non-appearance, and timely claim denial. This mechanical approach provides clarity for both insurers and practitioners, eliminating subjective interpretations about whether EUO objections may be futile based on the insurer’s stated reasons.
