Pre and post claim EUO

Pre and Post Claim EUO: Timing Doesn’t Invalidate the Process

No-fault insurance disputes often hinge on procedural requirements that can make or break a case. One recurring question in New York no-fault insurance law involves the timing of Examinations Under Oath (EUOs) — specifically whether an insurance company can schedule an EUO before receiving a formal claim form versus after the claim has been submitted.

The Appellate Term recently addressed this timing issue in a decision that clarifies an important procedural point for healthcare providers and insurers alike. This case demonstrates how courts continue to refine the boundaries of no-fault procedures, particularly regarding EUO requirements and their enforcement.

Jason Tenenbaum’s Analysis:

Longevity Med. Supply, Inc. v Nationwide Ins., 2020 NY Slip Op 51133(U)(App. Term 2d Dept. 2020)

“Plaintiff failed to raise a triable issue of fact in opposition. Contrary to the Civil Court’s determination, “appearance at an is required whether the insurance company demands the before the claim form is submitted or after the claim form is submitted” (Stephen Fogel Psychological, P.C., 35 AD3d at 721; LDE Med. Servs., P.C. v Interboro Ins. Co., 31 Misc 3d 146, 2011 NY Slip Op 50946 ). Consequently, although the first EUO scheduling letter was mailed to the assignor before defendant received plaintiff’s first claim form, the scheduling letter was not a nullity (id.).:

It is funny watching some courts grapple with the effect a pre claim or a post claim EUO has on a matter.

Key Takeaway

The timing of when an insurance company schedules an EUO — whether before or after receiving a claim form — does not affect the validity of the EUO requirement. Courts have consistently held that appearance at an EUO is mandatory regardless of when the insurer makes the demand, settling a procedural question that has created confusion in lower courts.