The no-fault regulations permit insurers, in order to verify a claim, to request examinations under oath (EUOs) of applicants for benefits. This tool was unavailable to insurers prior to the enactment of the “new regulations” on April 5, 2002. The Appellate Term, First Department, had previously held that in order for an insurer to prevail on a denial of claim where such denial was based on an applicant’s failure to appear for an EUO, the insurer must first establish that the underlying insurance policy contained an endorsement authorizing EUOs and that such policy was issued or renewed on or after April 5, 2002.1

In Dover Acupuncture v. State Farm Mut. Auto. Ins. Co.,2 defendant made a motion for summary judgment based on plaintiff’s assignor’s failure to appear for EUOs. The lower court denied defendant’s motion, and defendant appealed. In reversing the lower court and granting summary judgment to defendant, the Appellate Term, First Department, held, in relevant part:

Defendant was not required to produce the applicable automobile insurance policy in order to establish that the mandatory personal injury endorsement included an EUO provision, since the subject claim arose out of an accident that occurred in 2007, at a time the policy necessarily would have contained such a provision (citations omitted). In any event, even assuming, arguendo, that the policy did not contain an EUO provision, the policy would be construed as though it did (see Insurance Law §5103[h]).

This content has been archived. It is available through our partners, LexisNexis® and Bloomberg Law.

To view this content, please continue to their sites.

Not a Lexis Subscriber?
Subscribe Now

Not a Bloomberg Law Subscriber?
Subscribe Now

Why am I seeing this?

LexisNexis® and Bloomberg Law are third party online distributors of the broad collection of current and archived versions of ALM's legal news publications. LexisNexis® and Bloomberg Law customers are able to access and use ALM's content, including content from the National Law Journal, The American Lawyer, Legaltech News, The New York Law Journal, and Corporate Counsel, as well as other sources of legal information.

For questions call 1-877-256-2472 or contact us at [email protected]