Have You or a Loved One Been Summoned to an Examination Under Oath?
After a car accident involving injuries, an Examination Under Oath (EUO) gives an opportunity for a representative of a car insurance carrier to question their insured under oath in the presence of a court reporter. As a policyholder, you are required to comply as part of the car insurance company’s accident 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 Examination Under Oath is to determine:
- Was their coverage at the time of the accident? (any material misrepresentations on the PIP application?)
- Was there a legitimate accident?
- Was there a resulting injury?
- Is/was the medical treatment being received reasonable and necessary?
The obligation to submit to an EUO is codified in Florida Statutes but 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 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. That is not to say that you cannot reschedule, within reason, but you cannot unreasonably 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. it would be unreasonable to only be available on Saturday at 5:00 am in two years).
What an EUO Is Not:
An EUO 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.), an Examination Under Oath 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.All reasonable questions allowed and there are much fewer objections allowed.
How to Prepare for an EUO Examination:
First, get your personal injury lawyer a copy of your car insurance application.An adjuster will usually take the EUO, but some car accident insurance companies retain defense counsel (lawyers who tend to represent insurance companies instead of the injured). Information from recorded statements, further investigation may direct the line of questioning. Tell the truth. If they catch you in a lie re any material item related to the policy may void the policy. Good/valid questions: 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? They will compare what you say at a recorded statement and what you put in your insurance application to what is said at EUO. Your car insurance application is a common source of gotcha questions used to show you lied to the insurance company. Court decisions have ruled that you may refuse to respond to wholly impertinent and improper questions (such as unrelated criminal history) which had 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).
Why Is The Car Insurance Application So Important?
More often than not, when we receive a request for an EUO Examination, it is because the car accident insurance company believes that there might be a material misrepresentation in the insurance application that they might use to disclaim coverage.The car insurance company (e.g. State Farm, GEICO, Nationwide, Allstate, Progressive, USAA, United Auto, Infinity, Imperial Fire, Liberty Mutual, Foremost, Direct General, etc.) uses your application to determine what premiums to charge you. Common questions where people feel compelled to misrepresent themselves are:
- How many People (of Driving Age) Live in the Household? or How Many Cars are Parked at the Household?
Personal injury clients can get in trouble when they feel that the insurance company doesn’t need certain information. For example, if you have your niece, long-time girlfriend, aunt or grandmother living in your house, you may decide not to include this person because she won’t drive the cars listed on the auto insurance policy. Perhaps she drives her own car with its own separate policy. While this makes sense, it is also a misrepresentation on your insurance application. The question becomes relevant because your niece/girlfriend/grandmother could drive one of the vehicles listed on your policy.
Naturally, it follows then she could get into an automobile accident with one of the insured vehicles and the car insurance company, then, might want to charge a slightly higher premium for this slightly higher risk.Once a client claimed that a car she owned but was not listed on her insurance application, was broken down and not driven by anyone, which is why it is wasn’t listed on the application (if this were true, it would be a valid reason). However, the insurance company ran a report about 300 pages long that showed the car (verified by license plate) traveling all around the state (traffic cameras now capture almost each and every license plate and keep these records for long periods of time). It turned out that my client bought the car to help a friend who was unable to get insurance or financing. Unfortunately, this nice gesture cost my client a lot of money.
What Questions Are Allowed in an Examination Under Oath?
Policy sets guidelines. But all EUO 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.
Common EUO Questions
- What is your address?
- Who do you live with?
- How many cars are parked at your residence?
- 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 traveling on?
- What road were you traveling 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?