Key Takeaway
New York court ruling clarifies that insurance companies don't need objective reasons to request examinations under oath in no-fault cases, creating legal precedent.
Understanding EUO Requirements: The Objective Standards Debate
The question of whether insurance companies must provide objective reasons when requesting examinations under oath (EUOs) has created a notable split among New York courts. This fundamental issue affects how New York No-Fault Insurance Law cases proceed, particularly when healthcare providers challenge the reasonableness of EUO demands.
EUOs are powerful investigative tools that allow insurers to question claimants under oath about their insurance claims. However, the legal standards governing when these examinations can be requested have been inconsistently applied across different jurisdictions. Some courts have required insurers to demonstrate objective reasons justifying their EUO requests, while others have taken a more permissive approach.
The case discussed below represents one side of this judicial divide, offering important guidance for both insurance companies and healthcare providers navigating no-fault disputes. Understanding these standards is crucial when dealing with EUO objections or situations where parties fail to appear for scheduled examinations.
Jason Tenenbaum’s Analysis:
21st Century Pharm., Inc. v Integon Natl. Ins. Co., 2020 NY Slip Op 51364(U)(App. Term 2d Dept. 2020)
“Plaintiff does not argue that defendant did not demonstrate its prima facie case. Rather, plaintiff argues that defendant’s EUO requests were unreasonable. However, contrary to plaintiff’s contention, defendant was not required to set forth objective reasons for requesting EUOs in order to establish its prima facie entitlement to summary judgment (see Interboro Ins. Co. v Clennon, 113 AD3d 596 ; 21st Century Pharm., Inc. v Ameriprise Ins. Co., 65 Misc 3d 134, 2019 NY Slip Op 51629 ; Parisien v Metlife Auto & Home, 54 Misc 3d 143, 2017 NY Slip Op 50208 ). As plaintiff failed to raise a triable issue of fact, defendant is entitled to summary judgment dismissing the complaint.”
The split on objective reasons.
Key Takeaway
This decision reinforces that insurance companies are not required to provide objective justifications for EUO requests when seeking summary judgment in no-fault cases. The court’s ruling aligns with precedent favoring insurers’ broad authority to conduct examinations under oath, even when EUO no-shows or other complications arise during the claims process.
