Not attending an EUO at your own peril

Understanding the Risks of Missing Your Examination Under Oath

Under New York No-Fault Insurance Law, insurance companies have the right to require claimants to attend an Examination Under Oath (EUO) as part of their investigation process. These sworn examinations allow insurers to gather additional information about claims and verify their legitimacy. While claimants may sometimes object to EUO scheduling letters for various procedural reasons, a recent appellate court decision serves as a stark reminder that skipping these examinations can have devastating consequences.

The stakes are particularly high because failing to appear at a properly scheduled EUO can result in the complete denial of your no-fault benefits claim. This outcome occurs regardless of the underlying merits of your case. Insurance companies are well aware of these consequences and often use EUO requirements strategically in their claims handling process. As we’ve seen in various Allstate cases, even when claimants believe they have valid objections to the scheduling process, courts frequently side with insurers when claimants simply fail to appear.

Case Background and Procedural Context

The case of Accelerated Med. Supply, Inc. v Ameriprise Ins. Co. originated in District Court, where the plaintiff medical supply company challenged the procedural adequacy of EUO scheduling letters issued by the defendant insurer. The lower court’s ruling favored the plaintiff, finding that the scheduling letters contained fatal defects because they failed to specify which particular claims were the subject of the requested examinations. This specificity requirement exists to ensure that claimants receive adequate notice of what will be discussed during the EUO and can prepare accordingly.

On cross-motion, the District Court granted relief to the plaintiff, effectively allowing the no-fault claims to proceed despite the plaintiff’s failure to attend the scheduled examinations. The court’s reasoning centered on fundamental fairness principles: if the scheduling letters did not clearly identify the claims at issue, how could the plaintiff be expected to meaningfully participate in the examination? This procedural deficiency, the trial court concluded, excused the non-appearance.

However, the Appellate Term took a markedly different view of these same facts. The reversal reflects a broader judicial philosophy that places significant weight on claimants’ cooperation obligations in the no-fault claims process. Even where procedural irregularities exist in scheduling communications, courts increasingly recognize that the remedy for such defects should be objection and clarification, not unilateral non-appearance.

Jason Tenenbaum’s Analysis:

Accelerated Med. Supply, Inc. v Ameriprise Ins. Co., 2020 NY Slip Op 50741(U)(App. Term 2d Dept. 2020)

In an order dated April 12, 2017, the District Court denied defendant’s motion, finding that the letters scheduling the EUOs of plaintiff were defective because they did not specify the claims to which the letters pertained, and the court granted plaintiff’s cross motion”.

Reversed.

I mean in the scheme of things, if you decide not to attend an EUO, you really do so at your own peril.

Legal Significance

This appellate reversal carries substantial implications for the interpretation of claimants’ cooperation obligations under New York’s no-fault insurance regime. The decision signals that appellate courts will not readily excuse non-appearance at examinations based on alleged procedural defects in scheduling letters. Rather than providing a safe harbor for avoiding EUOs, technical objections to scheduling procedures are increasingly viewed as issues to be raised and resolved through proper channels before the examination date.

The Accelerated Med. Supply decision aligns with a line of cases emphasizing that no-fault insurance operates on principles of prompt investigation and expeditious claim resolution. When claimants fail to appear for scheduled examinations, they frustrate these fundamental purposes, regardless of whether the scheduling letter contained every detail that might ideally be included. Courts recognize that insurers must be able to investigate claims effectively, and EUOs serve as a critical tool in that process.

The decision also reflects judicial economy concerns. If every minor deficiency in an EUO scheduling letter could serve as grounds for excusing non-appearance, litigation would become mired in preliminary disputes over procedural minutiae rather than addressing the substantive merits of claims.

Practical Implications

For medical providers, attorneys, and claimants operating in the no-fault insurance arena, this case provides several critical lessons. First, when faced with an EUO scheduling letter that appears deficient, the safest course is to attend the examination while preserving objections to any procedural defects. This approach protects against the devastating consequence of claim denial for non-cooperation while still preserving the right to challenge improper scheduling practices.

Second, practitioners should understand that trial court rulings favorable to claimants on EUO scheduling issues face significant reversal risk on appeal. Building litigation strategy around anticipated success on procedural objections to EUOs is hazardous, as appellate courts have demonstrated a clear preference for substance over form in this context.

Finally, this decision underscores the importance of proactive communication with insurers when scheduling issues arise. Rather than simply declining to appear based on perceived defects in scheduling letters, claimants and their counsel should seek clarification, request amended scheduling letters, or pursue other remedies that demonstrate good-faith cooperation efforts while protecting their procedural rights.

Key Takeaway

This case demonstrates that even when lower courts find procedural defects in EUO scheduling letters, appellate courts may still reverse those decisions in favor of insurance companies. The overarching principle remains clear: objections to EUOs may prove futile if you don’t attend, and the consequences of non-appearance typically outweigh any potential procedural arguments you might have.

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