What Is an “Examination Under Oath” and How Could It Affect My Florida No-Fault Insurance Benefits?

Florida law requires all drivers to carry “personal injury protection” (PIP) coverage as part of their standard auto insurance policy. PIP coverage is generally described as a type of no-fault insurance, as your insurer is expected to pay you medical and lost income benefits regardless of who was responsible for the underlying accident. But just because you have a no-fault policy, that does not mean your insurance company will not try to get out of paying you if it thinks there is a legal avenue for doing so.

The Examination Under Oath

Insurance companies commonly use a procedure called an examination under oath (EUO) as part of their claims process. Essentially, an EUO is where your insurance company requires you to give a deposition about your claim. Typically, an insurance company attorney will ask you questions. Of course, you have the right to have your own attorney present to advise you during the examination.

You are answering these questions under oath, which means in theory you could be prosecuted for perjury if you intentionally give false answers. Now, you would not face criminal prosecution for refusing to answer questions or simply not showing up for the EUO. But in those scenarios, your insurance company can cite a refusal to cooperate as grounds for denying your claim. Similarly, answers you give during an EUO may provide the insurer ammunition to argue they are not legally responsible for paying your claim.

Change of Address a “Misrepresentation” Invalidating Coverage

Indeed, a recent decision from the Florida Third District Court of Appeal illustrates how a seemingly innocuous admission during an EUO can lead to a denial of PIP benefits. In this case, Universal X Rays, Corp. v. United Automobile Insurance Company, an insured driver sustained injuries in an auto accident. The driver subsequently received medical care from Universal X Rays and assigned his PIP benefits to it.

The insurance company, however, denied the claim following a EUO of the driver. During the examination, the driver admitted that he moved to a new address just after filing his application for auto insurance. The application still contained the driver’s old address. The insurance company said that “misrepresentation” invalidated the insurance policy, ostensibly because had it known the driver’s new address it “would have charged a substantially higher premium.”

Universal X Rays subsequently sued the insurance company for breach of contract. But the circuit court, and later the Third District, sided with the insurer. As the Third District explained, the evidence from the EUO was “undisputed” that the driver misrepresented his address. The insurer was therefore within its rights to deny coverage.

Contact a Miami Car Accident Attorney Today

Following a car accident you are required to notify your insurance company in a timely manner in order to preserve your coverage rights. But you should not offer a more detailed statement or agree to an examination under oath without first speaking to a qualified Miami car accident attorney. Contact Pita Weber Del Prado in Miami today at 305-670-2889 to schedule a free consultation.

Source:

flcourts-media.flcourts.gov/content/download/2461793/opinion/Opinion_2024-0777.pdf