Key Takeaway
Learn EUO summary judgment requirements in NY no-fault cases. What insurance companies must prove vs. what they don't. Call 516-750-0595 for help.
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.
EUO Summary Judgment Requirements: What Insurance Companies Must Prove in New York
Understanding Prima Facie Requirements in EUO No-Show Cases
When healthcare providers fail to appear for scheduled Examinations Under Oath (EUOs), insurance companies often seek summary judgment to deny no-fault benefits claims. The decision in Actual Chiropractic, P.C. v State Farm Insurance clarifies what insurers must demonstrate to establish their prima facie entitlement to judgment, and notably, what they are not required to prove.
The Actual Chiropractic Decision: Key Legal Framework
In Actual Chiropractic, P.C. v State Farm Insurance, 2019 NY Slip Op 50421(U)(App. Term 2d Dept. 2019), the court addressed a crucial procedural question: must insurance companies provide objective reasons for requesting EUOs when seeking summary judgment for benefits denials?
The Court’s Clear Answer
The court definitively answered this question: No, insurance companies are not required to set forth objective reasons for requesting EUOs when establishing their prima facie entitlement to summary judgment. This ruling aligns with established precedent and simplifies the requirements for insurers seeking judgment in EUO no-show cases.
Prima Facie Requirements for EUO Summary Judgment
What Insurance Companies Must Prove
According to the Actual Chiropractic decision, citing Interboro Insurance Co. v Clennon, 113 AD3d 596, 597 (2014), insurers need only demonstrate “as a matter of law” three essential elements:
- Proper EUO Demand: That they “twice duly demanded an from the ”
- Provider’s Failure to Appear: That “the provider failed to appear” for the scheduled examinations
- Timely Denial: That “the issued a timely denial of the claims”
What Insurance Companies Are NOT Required to Prove
Importantly, the decision makes clear that insurers do not need to:
- Provide objective reasons or justification for the EUO request
- Demonstrate good cause for the examination
- Show suspicious circumstances warranting investigation
- Prove the reasonableness of the EUO demand
Supporting Case Law and Legal Authority
Consistent Precedent Across Departments
The Actual Chiropractic decision cites several supporting cases that establish this framework:
- Parisien v Metlife Auto & Home, 54 Misc 3d 143, 2017 NY Slip Op 50208
- Palafox PT, P.C. v State Farm Mutual Auto Insurance Co., 49 Misc 3d 144, 2015 NY Slip Op 51653
The Interesting “Compare” Citation
The decision includes an intriguing “cf.” (compare) citation to American Trust Insurance Co. v Jaga Medical Services, P.C., 128 AD3d 441 (2015). This reference subtly acknowledges that the First Department’s analysis in Jaga took a different approach, suggesting some judicial disagreement on these issues.
Practical Implications for Legal Practice
For Insurance Companies and Defense Counsel
This decision provides clear guidance for insurers seeking summary judgment in EUO no-show cases:
- Streamlined Requirements: Focus on proving the three essential elements without needing to justify the EUO request
- Burden Reduction: No need to develop extensive records showing suspicious circumstances
- Efficient Litigation: Faster path to summary judgment when providers fail to appear
For Healthcare Providers and Plaintiff’s Counsel
While this decision favors insurers, it clarifies the battlefield for healthcare providers:
- Challenge Procedure, Not Justification: Focus defenses on procedural compliance rather than reasonableness of EUO demands
- Attend EUOs: The best defense against summary judgment is compliance with EUO demands
- Documentation is Critical: Ensure all correspondence and scheduling issues are properly documented
Strategic Considerations in EUO Litigation
Beyond the Prima Facie Case
While insurers may not need to justify EUO demands initially, other legal theories remain available to challenge unreasonable examination requests:
- Claims of harassment through excessive EUO demands
- Procedural defects in EUO scheduling
- Constitutional due process challenges in extreme cases
- Bad faith claims where patterns of abuse emerge
The Broader No-Fault Context
EUO issues frequently intersect with other areas of no-fault practice, including car accident injury claims and broader personal injury litigation. Understanding EUO requirements helps attorneys address the complex interplay between no-fault benefits and tort recovery.
Connection to Other Legal Practice Areas
Personal Injury Cases and No-Fault Benefits
EUO compliance affects not only healthcare providers but also injured parties pursuing compensation. Clients involved in motor vehicle accidents often need to understand both their no-fault benefits and their right to pursue car accident injury claims against at-fault parties.
Healthcare Provider Representation
Medical practices, especially those treating accident victims, need skilled legal representation to navigate no-fault requirements while maintaining their right to compensation. This includes understanding EUO obligations and protecting against improper benefit denials.
Future Developments in EUO Law
Potential Legislative Changes
While current law clearly favors insurers in EUO summary judgment motions, ongoing discussions about no-fault reform may affect these requirements. Healthcare providers and legal practitioners should monitor potential changes to No-Fault Regulations 68.
Appellate Court Harmonization
The “cf.” citation to Jaga suggests some tension between different appellate departments. Future decisions may need to address any inconsistencies in how courts approach EUO justification requirements.
Frequently Asked Questions About EUO Summary Judgment
What must insurance companies prove to get summary judgment when providers miss EUOs?
Insurance companies must prove three elements: (1) they twice properly demanded EUOs from the provider, (2) the provider failed to appear, and (3) they issued timely denials of the claims. They do not need to justify why they requested the EUOs.
Can healthcare providers challenge EUO demands as unreasonable?
While providers cannot challenge the lack of objective justification for EUO demands in summary judgment proceedings, they may still challenge EUOs on other grounds such as procedural defects, harassment, or bad faith patterns of conduct.
What happens if a provider partially complies with EUO demands?
Partial compliance may not satisfy the insurer’s requirements. Providers should attend all scheduled EUOs and comply fully with reasonable requests to avoid potential benefits denials.
How does this decision affect ongoing no-fault litigation?
The decision clarifies that insurers have a relatively low burden for establishing prima facie entitlement to summary judgment in EUO no-show cases. This may encourage more aggressive summary judgment motions by insurers.
Should healthcare providers always attend EUOs?
Generally, yes. The best protection against summary judgment and benefits denial is compliance with properly scheduled EUO demands. Providers should consult with experienced counsel if they believe an EUO demand is improper or harassing.
Conclusion
The Actual Chiropractic decision provides valuable clarity for both insurers and healthcare providers navigating New York’s no-fault system. By establishing clear, limited requirements for EUO summary judgment motions, the court has streamlined the process for insurers while clarifying the legal landscape for providers and their counsel.
Understanding these requirements is crucial for effective legal representation in no-fault disputes. While the decision favors insurers in many respects, it also provides a clear roadmap for both sides to understand their rights and obligations in EUO proceedings.
Whether you’re a healthcare provider dealing with EUO demands, an injured party navigating no-fault benefits, or an attorney handling insurance disputes, experienced legal guidance can help protect your rights and interests in these complex proceedings.
Call 516-750-0595 for a free consultation with an experienced New York no-fault insurance attorney who can help you understand your rights and develop effective strategies for EUO compliance and insurance claim disputes.
Related Articles
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.
Keep Reading
More EUO issues Analysis
EUO No-Show: Attorney Affirmation Sufficient Despite Time Lapse Between No-Shows and Execution
Appellate Term reverses Civil Court, holding that an attorney's affirmation attesting to plaintiff's failure to appear at EUOs was sufficient despite a 'significant lapse in time.'...
Feb 25, 2026
EUO no-show – correct statement of law
Court ruling clarifies that insurers cannot enforce EUO requests sent more than 30 days after receiving claims, making late requests nullities under New York no-fault law.
May 22, 2021
Alrof Safeco made another sighting
Court rejects insurance company's EUO no-show motion due to defective affidavit lacking personal knowledge, highlighting critical evidentiary requirements in no-fault cases.
Jul 16, 2013
How to Challenge EUO No-Show Denials: When Improper Notice Can Reverse Insurance Denials in New York
Learn how to challenge EUO no-show denials when insurance companies fail to prove proper notice. Expert legal strategies for NY cases. Call 516-750-0595.
Oct 22, 2019
Timely EUO letters
Court clarifies that EUO scheduling letters must be sent within 30 days of claim receipt, reinforcing timing requirements under New York no-fault insurance law.
Dec 15, 2016
EUO time-frame according to the Appellate Term Second Department
New York appellate court clarifies strict 15-day deadline for no-fault insurers to request EUOs, ruling that late scheduling letters are nullities under regulations.
Apr 14, 2015Was this article helpful?
About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
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.
If you need legal help with a euo issues matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.
