EUO no show – plain and to the point

Understanding Examinations Under Oath in New York No-Fault Insurance

If your insurance company has scheduled you for an Examination Under Oath (EUO), showing up isn’t optional—it’s essential to keeping your no-fault benefits. Missing this appointment can result in immediate denial of your entire claim, leaving you responsible for thousands of dollars in medical bills and lost wages.

An Examination Under Oath is a formal procedure where you’re required to answer questions about your accident, injuries, and treatments under oath, similar to a deposition in a lawsuit. Insurance companies use EUOs as a tool to verify the legitimacy of claims and gather additional information about your case.

The recent case of Quality Health Supply Corp. v Nationwide Ins., 2023 NY Slip Op 02689 (2d Dept. 2023), demonstrates exactly what happens when claimants fail to appear for scheduled EUOs—and why the consequences are so severe.

Legal Framework: The Rules Insurance Companies Must Follow

The 15-Day Rule for Additional Verification

New York law gives insurance companies specific deadlines for requesting additional information:

“Upon receipt of one or more of the prescribed verification forms used to establish proof of claim… an insurer has 15 business days within which to request ‘any additional verification required by the insurer to establish proof of claim’” (Hospital for Joint Diseases v Travelers Prop. Cas. Ins. Co., 9 NY3d 312).

The 30-Day Follow-Up Requirement

If you don’t provide requested verification within 30 days, insurance companies must follow specific procedures:

“At a minimum, if any requested verifications has not been supplied to the insurer 30 calendar days after the original request, the insurer shall, within 10 calendar days, follow up with the party from whom the verification was requested” (11 NYCRR 65-3.6).

The Consequences of EUO No-Shows

The law is clear about what happens when you miss your EUO:

“The failure to comply with the provision of an insurance policy requiring the insured to submit to an examination under oath… is a material breach of the policy, precluding recovery of the policy proceeds” (Nationwide Affinity Ins. Co. of Am. v George, 183 AD3d 755).

This means that missing your EUO isn’t just a minor scheduling issue—it’s considered a breach of your insurance contract that can eliminate your right to benefits entirely.

What This Means For You

EUO Attendance Is Mandatory

Unlike regular medical appointments that you can reschedule if needed, EUO appointments are contractual obligations. Your no-fault insurance policy requires your cooperation with the EUO process as a condition of receiving benefits.

Proper Notice Must Be Given

Insurance companies can’t schedule EUOs on a whim. They must:

• Follow proper timelines (within 15 days of receiving your initial claim forms)
• Provide adequate notice of the EUO appointment
• Follow up appropriately if you don’t respond within 30 days
• Issue denials only after following all required procedures

The Difference Between No-Shows and Mutual Rescheduling

The Quality Health Supply case addressed an important distinction: there’s a difference between failing to appear for an EUO and mutually agreeing to reschedule. If you work with the insurance company to reschedule due to legitimate reasons, this typically doesn’t constitute a “no-show.”

However, if the insurance company gives you multiple chances (third or fourth attempts) despite previous no-shows, any subsequent denial might be considered untimely under certain court decisions.

How EUO Scheduling and Denial Process Works

Initial Claim Submission

• You submit your no-fault claim forms to the insurance company
• Insurance company has 15 business days to request additional verification
• EUO request is typically made during this 15-day window

EUO Scheduling Phase

• Insurance company sends formal letter scheduling your EUO
• Letter must be properly addressed and mailed
• You’re given reasonable notice of the appointment date and time

The Critical 30-Day Period

• If you don’t respond or appear within 30 days, insurance company must send follow-up notice
• This follow-up must occur within 10 calendar days of the 30-day deadline
• After proper follow-up, insurance company can proceed with denial process

Common Reasons People Miss EUOs

Lack of Understanding: Many claimants don’t realize how serious EUO appointments are or understand the consequences of missing them.

Fear or Anxiety: The formal nature of EUOs can be intimidating, leading some people to avoid the appointment altogether.

Scheduling Conflicts: Work, medical appointments, or family obligations may seem more pressing than the EUO.

Poor Communication: Sometimes the EUO notice gets lost in mail, or contact information isn’t current.

Inadequate Legal Representation: Without proper legal guidance, claimants may not understand their obligations or how to handle EUO requests appropriately.

Protecting Your Rights During the EUO Process

Respond Immediately to EUO Letters

As soon as you receive an EUO scheduling letter:

• Contact your attorney immediately if you have representation
• If you need to reschedule, contact the insurance company promptly
• Don’t ignore the letter hoping it will go away

Understand What to Expect

EUOs typically involve questions about:

• The circumstances of your accident
• Your injuries and how they affect your daily life
• Your medical treatment and providers
• Your employment and wage loss
• Any previous accidents or injuries

Prepare Properly

Before your EUO:

• Review all documents related to your accident and treatment
• Organize medical records, bills, and correspondence
• Discuss potential questions and proper responses with your attorney
• Ensure you understand your obligations and rights

The Strategic Implications of EUO Cases

Insurance Company Tactics

Insurance companies use EUOs strategically to:

• Identify inconsistencies in claimant statements
• Gather information for potential fraud investigations
• Create opportunities for claim denials through procedural non-compliance
• Delay claim processing while building defense strategies

The Importance of Legal Representation

Having an experienced no-fault attorney during the EUO process provides crucial advantages:

• Proper preparation for questioning
• Understanding of your rights during the examination
• Ability to object to inappropriate questions
• Knowledge of procedural requirements that insurance companies must follow
• Protection against unfair tactics or intimidation

Frequently Asked Questions About EUOs

Q: Can I bring my attorney to the EUO?

A: Yes, you have the right to have your attorney present during the EUO. In fact, it’s highly recommended. Your attorney can help ensure questions are appropriate and protect your rights throughout the process.

Q: What happens if I reschedule my EUO multiple times?

A: While you may have legitimate reasons for rescheduling, multiple rescheduling attempts can work against you. Insurance companies may view this as lack of cooperation and may eventually proceed with denial proceedings.

Q: Can insurance companies ask about my entire medical history during an EUO?

A: EUO questions must be relevant to your current claim. While insurance companies can ask about previous injuries or treatments that might relate to your current condition, they cannot conduct unlimited fishing expeditions into unrelated medical history.

Q: How long does an EUO typically last?

A: Most EUOs last between 2-4 hours, depending on the complexity of your case and the number of questions the insurance company’s representative has prepared.

Q: What if I made honest mistakes in my original claim forms that come up during the EUO?

A: Honest mistakes can usually be clarified and corrected during the EUO process. However, significant discrepancies or what appear to be intentional misrepresentations can create serious problems for your claim.

Moving Forward After EUO Issues

The Quality Health Supply decision reflects broader tensions in New York’s no-fault insurance system. This decision shows that courts will enforce procedural requirements strictly, but they also expect insurance companies to follow proper procedures before denying claims.

Whether you’re facing your first EUO request or dealing with complications from a missed appointment, having experienced legal representation can mean the difference between receiving the benefits you deserve and losing your claim entirely.

Call 516-750-0595 for a free consultation with our no-fault insurance attorneys. We understand the EUO process, know how to prepare you for success, and can protect your rights throughout the examination. Don’t let a missed appointment or procedural mistake cost you the benefits you need for your recovery.