Danger of rescheduling an EUO after the second no show

No-fault insurance disputes often hinge on procedural requirements that both insurers and claimants must follow precisely. One critical area involves Examinations Under Oath (EUOs), which insurance companies use to investigate potentially fraudulent or questionable claims. When a claimant fails to appear for scheduled EUOs, insurers must act decisively to preserve their right to deny coverage.

The timing and manner of claim denials following missed EUOs can make or break an insurance company’s defense. Under New York No-Fault Insurance Law, insurers have specific procedural obligations when claimants fail to comply with EUO requests. Missing these deadlines or improperly handling the denial process can result in waiving the insurer’s right to contest the claim entirely.

A recent appellate decision highlights a costly mistake that insurance companies sometimes make: continuing to reschedule EUOs after multiple no-shows instead of promptly denying the claim. This procedural misstep can have significant financial consequences, as EUOs represent a crucial $5,000 threshold in no-fault insurance disputes.

Jason Tenenbaum’s Analysis:

Pavlova v 21st Century Ins. Co., 2022 NY Slip Op 50363(U)(App. Term 2d Dept. 2022)

The danger of rescheduling after a second no-show. “Plaintiff correctly argues that defendant’s motion failed to establish that defendant had timely denied plaintiff’s claim after plaintiff’s assignor had allegedly failed to appear at both an initial and a follow-up EUO. Quality Health Supply Corp. v Nationwide Ins., 69 Misc 3d 133, 2020 NY Slip Op 51226 ).”

Key Takeaway

Insurance companies must act swiftly after claimants miss multiple EUO appointments. Continuing to reschedule examinations rather than issuing timely claim denials can waive the insurer’s right to contest coverage. The Pavlova decision reinforces that procedural compliance in no-fault cases requires decisive action, not endless accommodation of non-compliant claimants.