What types of clients do you represent?
What types of claims do you handle?
What if I have been injured and think I have a case?
How much is my case worth?
What are your fees and do I have to pay anything up front?
Who from your law firm will work on my case?
Will I have to attend court hearings?
What is a deposition?
What are compensatory damages?
What are punitive damages?
Will you speak with me before settling my case?
If my case settles, how long will it take before I receive money?
What is an impairment rating?
How do you begin to investigate a medical malpractice case?
What is a brachial-plexus injury?
How is a trucking accident different than a car accident?
When can you sue homeowner’s insurance?
What is the difference between EMG and NCV test?
What is a physiatrist?
Do I have to pay back health insurance?
When can I sue my landlord or property manager?
What is a biomechanical engineer?
How do I interpret my hospital records?
What is a letter of protection?
What is an offer of judgment or demand for judgment?
What goes into a settlement demand package?
Are there different rules when bringing an injury claim against the government in Florida?
What is a pre-settlement loan?
What is workers compensation?
What is the statute of limitations?
What is a traumatic brain injury?
What is the difference between an MRI, CT Scan and X-Ray?
What is the difference between an orthopedic doctor, physical therapist and chiropractor?
What is uninsured-motorist coverage?
Do I need a personal injury attorney if I am in a minor car accident?
What is my case worth?
What is an Examination Under Oath (EUO)?
Gives an opportunity for a representative of insurance carrier to question their insured, under oath, in the presence of a court reporter. As a policy holder, you are required to comply as part of the insurance company’s claims investigation process. It is a contractual obligation. The insurance company has no duty to perform its major responsibility (to cover your losses) unless you comply with the terms of the contract.
The purpose of an EUO is to determine:
1. Was their coverage at the time of the accident? (any misrepresentations on the PIP application)
2. Was there a legitimate accident?
3. Was there a resulting injury?
4. Is/was the medical treatment being received reasonable and necessary?
The obligation of the insured to submit to an EUO goes back over a century. There is a US Supreme Court case called Claflin v. Commonwealth Ins. Co. from 1884 that explains how the insurance company has a right to obtain all information with regard to facts material to their rights so that they may determine the extent of their obligation and to “protect them against false claims.” That last part is essentially the real purpose of an EUO — your auto carrier is looking for a reason to deny coverage.
If you fail to appear for an EUO – it will be deemed “willful noncompliance” of the terms in your insurance policy. You are certainly able to reschedule, within reason, but you cannot unnecessarily delay the examination. Normal scheduling conflicts are normal and no insurance company can deem you in breach of their insurance contract for trying to reschedule at another reasonable time and date (i.e. can’t only be available on Saturday at 5:00am, two years from now).
What an EUO is not
An Examination Under Oath is not a recorded statement (a verbal statement, usually over the phone, made by the insured and recorded by the insurer’s representative). Just because you gave a recorded statement, does not mean you can opt out of the EUO. They are not the same thing and both may be required.
An EUO is not a deposition. While their structure is similar (right to an attorney, court reporter present and swearing in, etc…) EUO is part of the claims investigation process and is requested prior to the filing of a lawsuit. It provides the carrier with information that will contribute to its decision to provide, limit or outright deny coverage.
Click here to read about what EUO questions are allowed.
What EUO questions are allowed?
The insurance policy sets the guidelines. But all questions relevant to the claim/loss or the policy must be answered. Any subject relevant to the insurer’s investigation is relevant. Refusal to answer may result in legitimate denial of a claim. Even irrelevant questions that MAY lead to relevant information is allowed.
Good/valid EUO questions will be related to: scope of the loss, events leading up to the loss, where were you coming from/going…what you did right after the accident; opinion as to who was at fault and why? What type of treatments received at the doctor?
You may refuse to respond to wholly impertinent, improper or intrusive questions into the insured’s personal life (such as unrelated criminal history) which obviously has nothing to do with the merits of the claim. This notion was specifically upheld in De Leon v. Great American Assur. Co., 78 So. 3d 585 (Fla. 3d DCA 2011).
How to Prepare for an Examination Under Oath
Adjuster may be there and they may use information from recorded statements and further investigation may direct the line of questioning. So review the recorded statement. Take a look at initial medical documents. Tell the truth. If they catch you in a lie re: any material item related to the policy may lead to your insurance company voiding the policy or denying coverage.
Find and review, with your personal injury attorney, your auto-insurance application. The adjuster will look at your driver’s license to make sure the address listed matches the one on your policy. A common “gotcha” area is where they ask about how many drivers, cars and people living are in your household. They will compare these answers to your original auto-insurance application. If there are differences, the carrier may claim you made a material misrepresentation in your application for insurance – another common reason why coverage may be denied.
Common EUO Questions
– How are you doing? (don’t say “great, good or fine…” if you are, in fact, injured and in pain)
– What did you say to the police?
– Was the other car drivable?
– What was the color of the other car?
– How many people in that other car?
– Did you see the other car before the accident?
– Did your lawyer advise you to go to that particular doctor/clinic?
– How did you hear about the doctor? i.e. what brought you to the center.
– Has the clinic/medical provider asked you to pay anything (20% or deductible).
– Have you had alcohol in the last 24 hours?
– How long have you lived at your current address?
– Describe what happened in the accident?
– What part of your car sustained damage?
– What lane were you in?
– How many lanes on the road you were travelling on?
– What road were you travelling on, in what direction?
– How fast were you going?
– Describe what your doctor looks like.
– Describe what the doctor’s assistants look like.
– Describe the building? On what floor is the therapy center located?
– How many times have you been for therapy?
– How many times have you seen the doctor, specifically (not an assistant)?
– Describe your first encounter with the doctor (initial exam).
– How long did the initial exam take?
– Did the doctor conduct ROM tests, make you stand up, sit down or lie down?
– What other treatments or modalities do you typically receive?
– Does the doctor perform any treatments, or all conducted by assistants?
– Does the doctor or receptionist make you sign in?
– Does the doctor or receptionist make you sign off on the treatments provided each time you go in for therapy?
– Do you think the treatments are working?
– Do you have any prior related medical conditions?