An objective basis is not needed (again) to schedule an EUO

Flow Chiropractic, P.C. v Travelers Home & Mar. Ins. Co., 2014 NY Slip Op 51142(U)(App. Term 2d Dept. 2014)

“On appeal, plaintiff argues that defendant lacked justification for its EUO requests and that the document demands contained in the EUO requests were palpably improper.

An appearance at an EUO “is a condition precedent to the insurer’s liability on the policy” (Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 722 [2006]). Plaintiff’s contention that defendant was not entitled to summary judgment because defendant had failed to set forth any objective standards for requesting the EUOs lacks merit. No “provision of No-Fault Regulations 68 requires an insurer’s notice of scheduling an EUO to specify the reason(s) why the insurer is requiring the EUOs” (2006 Ops Ins Dept No. 06-12-16 [http://www.dfs.ny.gov/insurance/ogco2006/rg061216.htm]).”

If an insurance carrier does not need to specify why an EUO is being held, then does the IP or provider have the right to object to being subjected to an EUO?  The answer is probably not.  Again, objections might be limited to location and time of the EUO.  But the basic premise that one must show up to an EUO at the carrier’s whim is probably good law.  IDS v. Stracar bears that premise out.

One Response to “An objective basis is not needed (again) to schedule an EUO”

  • ALAN Klaus:

    Once again stupid law. The carrier can ask a Provider to show up for an Euo on every bill with absolutely no reason except hoping the provider doesn’t show so they can deny the claim and u r saying that would b fine and not prejudicial. Really seriously. SMDH

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