Certified Mail and Regular Mail

EUO Notice Requirements: Regular Mail Versus Certified Mail

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. This technical objection reflects a misunderstanding of New York’s notice requirements for EUO scheduling. The Appellate Term decision in Central Park Physical Medicine & Rehab. clarifies that regular first-class mail is perfectly adequate for EUO scheduling notices, and certified mail is not required unless specifically mandated by statute or regulation.

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 or whether objections based on mailing methods lack merit.

The case also reinforces the broader principle 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, and technical objections about mailing methods rarely succeed absent specific statutory or regulatory requirements.

Central Park Physical Medicine & Rehab., P.C. v IDS Prop. & Cas. Ins. Co., 2019 NY Slip Op 51148(U)(App. Term 2d Dept. 2019)

Case Background

The defendant insurance company scheduled EUOs for the plaintiff healthcare provider and sent scheduling letters by first-class mail. The plaintiff failed to appear for the scheduled EUOs, and the defendant subsequently denied the claims based on the EUO no-shows. The plaintiff challenged the denials in litigation, and the case proceeded through the District Court.

During the litigation, the defendant demonstrated that it had properly scheduled the EUOs by mailing notices to the plaintiff. The District Court found that while the defendant had failed to establish that a follow-up EUO scheduling letter had been mailed by certified mail, this finding did not excuse the plaintiff’s failure to appear for the duly scheduled examinations. The plaintiff appealed, arguing that the absence of certified mail meant the EUO scheduling was improper and that the resulting claim denials should be invalidated.

The Appellate Term reviewed whether the use of first-class mail instead of certified mail for EUO scheduling letters rendered the scheduling insufficient, potentially excusing the plaintiff’s no-show and invalidating the insurance company’s subsequent claim denials.

Jason’s Analysis

(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 “

Legal Significance

The Central Park Physical Medicine decision establishes that New York law does not require certified mail for EUO scheduling notices in no-fault cases. Unless specific statutes or regulations mandate a particular mailing method, insurance companies may use ordinary first-class mail to schedule EUOs, and such notices constitute adequate notice requiring the provider’s attendance. This ruling rejects attempts by providers to avoid EUO obligations through technical objections about mailing methods.

The decision also clarifies the burden of proof in EUO no-show cases. Once the insurance company demonstrates that it mailed EUO scheduling letters by an acceptable method (including regular mail) and that the provider failed to appear, the burden shifts to the provider to raise triable issues of fact about the adequacy of notice. Mere speculation that certified mail might provide better proof of delivery does not create a factual issue excusing non-appearance.

Furthermore, the court’s analysis reinforces that proper notice analysis focuses on whether the chosen mailing method was “insufficient,” not whether a different method might have been preferable. Absent evidence that first-class mail was inadequate under the circumstances, providers cannot successfully challenge EUO scheduling based solely on the absence of certified mail.

Practical Implications

For insurance companies defending no-fault claims, this decision provides important protection for EUO scheduling practices. Insurers need not incur the additional expense and administrative burden of certified mail for EUO scheduling letters unless specifically required by applicable law. Regular first-class mail suffices, allowing companies to schedule examinations efficiently while maintaining the ability to deny claims when providers fail to appear for properly scheduled EUOs.

Healthcare providers and their attorneys should recognize that challenging EUO scheduling based on the absence of certified mail represents a weak argument unlikely to succeed. Resources spent on such challenges would be better directed toward substantive defenses or ensuring attendance at scheduled examinations. When providers believe they did not receive EUO scheduling letters, they should present affirmative evidence of non-receipt rather than relying on technical arguments about mailing methods.

The decision also highlights the importance of maintaining proper mailing records. While certified mail is not required, insurance companies should maintain documentation proving that EUO letters were sent by whatever method they choose. Affidavits from mail processing personnel, office mailing logs, and other proof of mailing become critical when providers claim non-receipt, as courts require evidence that scheduling letters were actually sent.

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.

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