EUOs

Understanding EUO Requirements: Recent New York Court Decisions

Examinations Under Oath (EUOs) play a crucial role in New York No-Fault Insurance Law disputes between healthcare providers and insurers. Two recent appellate court decisions from 2019 provide important clarification on the standards insurers must meet when seeking summary judgment based on EUO non-compliance, and address common procedural issues that arise in these cases.

These rulings are particularly significant for healthcare providers who regularly deal with EUO requests, as they establish clear precedents regarding what insurers must prove to successfully defend denial of claims. Understanding these requirements can help providers better navigate EUO objections and compliance issues that frequently arise in no-fault litigation.

Jason Tenenbaum’s Analysis:

Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co., 2019 NY Slip Op 50759(U)(App. Term 2d Dept. 2019)

” 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 provider twice failed to appear and that the issued a timely denial of the claim[]”

Oleg’s Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co., 2019 NY Slip Op 50760(U)(App. Term 2d Dept. 2019)

“We note that an EUO request letter which lists a contact at defendant’s law firm which is different from the attorney at the same law firm signing the otherwise sufficient affirmation of nonappearance of plaintiff at the duly scheduled EUO does not raise a triable issue of fact.”

Key Takeaway

These decisions reinforce that insurers don’t need to justify their reasons for requesting EUOs to win summary judgment - they simply must prove proper notice, non-appearance, and timely denial. Minor discrepancies in attorney contact information don’t create valid defenses to EUO no-show claims.