Key Takeaway
MVAIC suffers another court defeat in no-fault insurance case, with appeals court denying summary judgment on coverage requirements and remedy exhaustion claims.
The Motor Vehicle Accident Indemnification Corporation (MVAIC) serves as New York’s safety net insurer, providing coverage when other insurance options are unavailable. However, MVAIC frequently challenges claims through various legal arguments, often unsuccessfully. The Omega Diagnostic Imaging case represents another example of MVAIC’s aggressive litigation strategy backfiring in court.
This decision from the Appellate Term demonstrates the ongoing tension between no-fault insurance providers and MVAIC over coverage determinations. Medical providers seeking reimbursement for services rendered to accident victims often face complex procedural hurdles when dealing with MVAIC claims.
Jason Tenenbaum’s Analysis:
Omega Diagnostic Imaging, P.C. v MVAIC, 2011 NY Slip Op 50432(U)(App. Term 1st Dept. 2011)
“In this action by plaintiff-provider to recover assigned first-party no-fault benefits, defendant MVAIC’s motion for summary judgment dismissing the claim based on plaintiff’s failure to establish that its assignor qualified for MVAIC coverage, was properly denied (see Matter of MVAIC v Interboro Med. Care & Diagnostic, PC, 73 AD3d 667 ; Englington Med., P.C. v Motor Veh. Acc. Indem. Corp. (___AD3d ___, 2011 NY Slip Op 00176 ). Nor has defendant established that plaintiff was required to “exhaust its remedies” prior to commencing this action”
When will MVAIC give up? By the way, the no fault cases that are being posted on 3/25/11 mark the first ones since the appointment of the new Presiding Justice of the Appellate Term, First Department, Justice Richard B. Lowe, III.
Key Takeaway
MVAIC’s attempt to avoid paying no-fault benefits by claiming the provider failed to establish coverage qualifications was rejected by the court. The decision reinforces that MVAIC cannot simply shift the burden of proving coverage eligibility to medical providers, nor can it require exhaustion of other remedies before litigation commences.
Related Articles
- New York No-Fault Insurance Law
- Understanding collateral estoppel in no-fault coverage disputes
- Appellate division summary judgment when loss was not an insured event
- Proof requirements for intentional accident claims
- Causation challenges in no-fault arbitration proceedings
Legal Update (February 2026): Since this 2011 post, MVAIC’s coverage requirements, claim procedures, and litigation strategies may have been modified through regulatory amendments or statutory changes. Additionally, appellate decisions over the past 15 years may have further clarified provider obligations and MVAIC’s burden of proof in coverage disputes. Practitioners should verify current MVAIC regulations and recent case law when handling similar coverage determination matters.
