Examinations Under Oath : New Insurance Claims Handling Practice

 

Insurance Exam Recorded Statement

Insurance Examination Under Oath

We have noticed a recent trend where insurance companies are now demanding that policyholders submit to an Examination Under Oath (EUO) as part of their routine “investigation” of your claim.

Insurance companies used to request these EUOs only when a claim was being made under suspicious circumstances, such as suspected fraud.  Not anymore.  EUOs are being used aggressively by some insurance companies as a way to look for reasons to deny your claim. These requests are becoming much more frequent and are fast becoming a secret weapon of the insurance companies.In fact, the recent changes to Florida’s Motor Vehicle No-Fault Law allows insurance companies to insist upon a EUO before paying any medical benefits on your behalf – even for a minor fender-bender incident.

            Florida Statutes, Section 627.736(6)(g) states: “An insured seeking benefits under ss. 627.730–627.7405, including an omnibus insured, must comply with the terms of the policy, which include, but are not limited to, submitting to an examination under oath. 

           The scope of questioning during the examination under oath is limited to relevant information, or information that could reasonably be expected to lead to relevant information. Compliance with this paragraph is a pre-condition to receiving benefits. An insurer who, as a general business practice as determined by the office, requests an examination under oath of an insured or an omnibus insured without a reasonable basis is subject to s. 626.9541.” 

This EUO language is also written (or soon will be) into most insurance policies, and is often contained in the “Your Duties” section of the policy.  For example, the actual language from one automobile policy states that you must:

“Allow us to take signed and recorded statements, including sworn statements and examinations under oath, and answer all reasonable questions we may ask, as often as we may reasonably require.”

Take careful note of the “as often as we may reasonably require” provision. In another example, the actual language from a homeowner’s policy states that you must:

“Submit to examination under oath, while not in the presence of any other ‘insured,’ and sign the same.”

You must attend the EUO when demanded by the insurance company, and failure to do so may lead to rightful denial of your claim.

These EUOs are conducted by experienced attorneys hired by the insurance company.  These are not friendly- let’s-just-chat, conversations. 

You should not attend the EUO without your attorney at your side.

While the insurance company has certain rights, you do too. By having an attorney, you can be certain that your rights are protected.  Your attorney will not allow the insurance company’s attorney to mislead you regarding the reason for the EUO, mis-state your answers, or bully and intimidate you.  Your attorney can also advise you as to how many EUOs are “reasonable,” what questions during the EUO are relevant to your claim, and in extreme cases whether or not you are waiving your right against self-incrimination.

These EUOs are serious business, and payment of your claim for insurance benefits is at stake.

If you would like more information about this, please call and speak to one of our attorneys.  We are Your Insurance Law Team, and we will be happy to discuss your claim or just answer questions about insurance coverage, at no cost or obligation to you.  Do not wait until your claim is denied to find out your rights.

Footnote:

Thank you to Florida Registered Paralegal Kent W Stoltz for authoring this article.