Key Takeaway
Court rules on 45-day submission rule for MVAIC claims, highlighting strict requirements for written justification when medical providers miss deadlines.
This article is part of our ongoing timely submissions of bills coverage, with 17 published articles analyzing timely submissions of bills issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
AR Med. Rehabilitation, P.C. v MVAIC, 2010 NY Slip Op 50828(U)(App. Term 2d Dept. 2010)
“It is undisputed that plaintiff was required to submit its claim form to MVAIC within 45 days after the services at issue were rendered and that plaintiff did not do so (see Insurance Department Regulations § 65-1.1; Nir v MVAIC, 17 Misc 3d 134, 2007 NY Slip Op 52124 ; NY Arthroscopy & Sports Medicine PLLC v Motor Veh. Acc. Indem. Corp., 15 Misc 3d 89 ). MVAIC’s denial of plaintiff’s claim for $3,903.92, based upon its untimely submission, also [*2]informed plaintiff that it could excuse the delay if plaintiff provided “written justification” for the delay (see Insurance Department Regulations § 65-3.3 ; see also Matter of Medical Socy. of State of NY v Serio, 100 NY2d 854, 862-863 ; Nir, 17 Misc 3d 134, 2007 NY Slip Op 52124). In opposition to MVAIC’s motion for summary judgment, plaintiff did not establish that it had provided MVAIC with a written justification for its untimely submission of the claim form seeking the sum of $3,903.92.”
Key cite the NY Arthroscopy case, a First Department case. It appears that the Appellate Term Second Department cites that First Department case more than any other case for the proposition that Plaintiff failed to offer a sufficient excuse to defeat an insurance carrier’s late notice motion. I hate to say this, but I will anyway. Why does MVAIC have it both ways? First, the failure to qualify someone as eligible to receive benefits is a non-precludable condition precedent to coverage. This is, to the best of my knowledge, the only non precludable condition precedent that exists in no-fault law. Second, should the provider or the injured person’s attorney attempt to qualify the injured person but the 45-days to submit the bill elapses, then MVAIC can deny all benefits.
Related Articles
- Timely submissions and MVAIC filing requirements
- What happens after the 45-day deadline passes
- Healthcare providers’ burden for explaining untimely bill submissions
- Triable issues of fact in 45-day rule cases
Legal Update (February 2026): Since this 2010 post, New York Insurance Department Regulations Part 65 governing no-fault insurance procedures may have been amended, including potential changes to the 45-day submission requirements under § 65-1.1 and written justification provisions under § 65-3.3. Practitioners should verify current regulatory provisions and recent case law interpretations regarding untimely claim submission procedures and acceptable justification standards.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
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Frequently Asked Questions
What is the deadline for submitting no-fault medical bills in New York?
Under 11 NYCRR §65-1.1, healthcare providers must submit no-fault billing within 45 days of the date of service. Late submissions can result in denial of the claim. The 45-day rule is strictly enforced, though providers may argue reasonable justification for late filing in limited circumstances.
What happens if a medical bill is submitted late?
If a no-fault bill is submitted more than 45 days after treatment, the insurer can deny the claim as untimely. This defense must be raised on the NF-10 denial form. If the provider can show a reasonable justification for the delay, the denial may be overturned, but this is a difficult burden to meet.
Does the 45-day rule apply to all no-fault claims?
The 45-day submission requirement applies specifically to healthcare providers submitting bills under no-fault. The injured person's application for benefits (NF-2) has a 30-day deadline from the accident. Different timelines apply to different types of claims within the no-fault system, so compliance with each deadline is critical.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a timely submissions of bills matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.