Key Takeaway
New York court clarifies that EUO scheduling letters sent by regular mail are sufficient - certified mail is not required for valid examination under oath notices.
When insurance companies schedule examinations under oath (EUOs) in New York no-fault cases, healthcare providers sometimes argue that proper notice wasn’t given if the scheduling letters weren’t sent by certified mail. However, a recent Appellate Term decision clarifies that regular first-class mail is perfectly adequate for EUO scheduling notices.
This distinction matters because EUO no-shows can have serious consequences for healthcare providers, including waiver of discovery rights and claim denials. Understanding the proper notice requirements helps providers and attorneys evaluate whether they have valid grounds to challenge an insurance company’s EUO scheduling procedures.
The case also reinforces that once an EUO is properly scheduled - regardless of the mailing method - providers must appear or face claim denials. As we’ve seen in other no-fault insurance cases, courts consistently uphold insurance companies’ right to conduct EUOs when proper notice is given.
Jason Tenenbaum’s Analysis:
Central Park Physical Medicine & Rehab., P.C. v IDS Prop. & Cas. Ins. Co., 2019 NY Slip Op 51148(U)(App. Term 2d Dept. 2019)
(1) “While the District Court held that defendant had failed to establish that the follow-up EUO scheduling letter had been mailed by certified mail, that finding, even if correct, would not excuse the failure of plaintiff to appear for the duly scheduled EUOs, since the record does not contain any evidence showing that the mailing of the EUO scheduling letters to plaintiff by first-class mail had been insufficient”
(2) “Defendant further demonstrated that plaintiff had failed to appear for the duly scheduled EUOs (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 ), and that defendant had timely mailed (see St. Vincent’s Hosp. of Richmond, 50 AD3d 1123) the denial of claim forms, which denied the claims on the ground that plaintiff had failed to appear for the duly scheduled EUOs. Plaintiff failed to raise a triable issue of fact in opposition to defendant’s prima facie showing “
Key Takeaway
Healthcare providers cannot avoid EUO obligations simply because scheduling letters were sent by regular mail rather than certified mail. Courts will uphold properly scheduled EUOs regardless of mailing method, and failure to appear typically results in valid claim denials that are difficult to challenge.
