Key Takeaway
New York Court of Appeals ruling requires insurers to show "due consideration" when denying late no-fault claims, changing how prima facie defenses must be established.
This article is part of our ongoing timely notice of claim coverage, with 30 published articles analyzing timely notice of claim 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.
“Due Consideration” Requirement Changes No-Fault Late Notice Defense Strategy
The landscape of no-fault insurance claim defenses shifted significantly with a 2011 New York appellate ruling that introduced a crucial procedural requirement. Insurance companies can no longer simply assert that a healthcare provider’s explanation for late submission was inadequate—they must now demonstrate they gave “due consideration” to the provider’s excuse.
This development affects how insurers handle violations of both the 45-day rule for initial claim submissions and the 30-day rule for supplemental documentation. The change represents a meaningful shift from purely procedural compliance toward a more substantive review standard, requiring insurers to engage with providers’ explanations rather than dismiss them outright.
Understanding this requirement is essential for both healthcare providers submitting claims and insurers defending against late notice allegations in the no-fault system.
Jason Tenenbaum’s Analysis:
Bronx Expert Radiology, P.C. v NYC Tr. Auth., 2011 NY Slip Op 51571(U)(App. Term 1st Dept. 2011)
Prima facie defenses to a 45-day or 30-day rule violation now requires “due consideration” to the explanation the provider gave. So the affidavit now reads: “We considered the excuse, and found it unavailing because….” That should do the trick.
“Defendant’s cross motion for summary judgment dismissing the complaint was properly denied as defendant failed to establish that it gave “due consideration” to the explanation offered by plaintiff for the late submission of its no-fault claims as required by the insurance regulations (see 11 NYCRR 65-3.5; Matter of Medical Socy. of State of NY v Serio, 100 NY2d 854, 863 ; Bronx Expert Radiology v Clarendon Natl. Ins. Co., 23 Misc 3d 133, 2009 NY Slip Op 50747 ).”
Key Takeaway
Insurance companies defending against late no-fault claims must now affirmatively demonstrate they gave “due consideration” to healthcare providers’ explanations for timely notice violations. This procedural shift requires insurers to substantively address excuses rather than simply asserting they were insufficient, fundamentally changing how prima facie defenses are established in late notice disputes.
Legal Update (February 2026): Since this 2011 post, New York’s no-fault regulations have undergone multiple amendments, including updates to 11 NYCRR 65-3 regarding timely notice requirements and procedural standards. The “due consideration” standard for late notice defenses may have been refined through subsequent regulatory changes or court interpretations. Practitioners should verify current provisions of Section 65-3.5 and related subsections to ensure compliance with current procedural requirements for late notice defenses.
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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 are the notice of claim requirements in New York?
For claims against municipalities, General Municipal Law §50-e requires a notice of claim within 90 days of the incident. For insurance claims, timely notice to the insurer is a condition precedent to coverage. Late notice can result in denial of benefits or dismissal of the claim, though courts may grant extensions in limited circumstances.
Can a late notice of claim be excused?
Under GML §50-e(5), courts have discretion to grant leave to serve a late notice of claim. Factors include whether the claimant was an infant or incapacitated, whether the municipality had actual knowledge of the claim, and whether the delay caused prejudice. For insurance claims, late notice is harder to excuse and typically requires demonstrating reasonable justification.
What happens if I fail to give timely notice to my insurer?
Failure to provide timely notice to your insurer can result in denial of your claim. In no-fault cases, the 30-day deadline for the NF-2 application is strictly enforced. For other insurance claims, the policy typically requires notice "as soon as practicable." Late notice gives the insurer a strong defense unless you can demonstrate a valid excuse.
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.
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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 notice of claim 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.
