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Another no-fault physician commits insurance fraud
No-Fault

Another no-fault physician commits insurance fraud

By Jason Tenenbaum 8 min read

Key Takeaway

Doctor convicted of insurance fraud for falsifying no-fault C-4 forms, showing patient as disabled when they were working. Court upheld conviction based on consistent witness testimony.

This article is part of our ongoing no-fault coverage, with 271 published articles analyzing no-fault 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.

The New York no-fault insurance system relies heavily on accurate medical reporting to function properly. When healthcare providers submit fraudulent documentation, it undermines the entire system and can result in serious criminal consequences. The case of People v Palmeri demonstrates how courts handle physicians who deliberately falsify required insurance forms.

No-fault C-4 forms are critical documents that medical providers must complete accurately when treating patients injured in motor vehicle accidents. These forms require physicians to assess whether a patient is totally disabled or capable of working — determinations that directly impact insurance benefits and coverage decisions under New York No-Fault Insurance Law.

Jason Tenenbaum’s Analysis:

People v Palmeri (Michael), 2012 NY Slip Op 22040 (App. Term 2d Dept. 2012)

It has just been an awful few months for the plaintiffs bar out there. First, many defacto owners of certain supply companies take guilty pleas, forfeit millions of dollars and end up with non-parolable 3-5 year sentences. Second, the feds in what appears to be the type of investigation known to stopping the Italian Mafia sends a well-deserved shock wave through our legal community. Now, a surgeon’s conviction for insurance fraud has been sustained. Just so you know, I am a month late on this one.

“The testimonies of the People’s witnesses appear truthful on their face, they are internally consistent as to material fact, and established that defendant knew, when he filled out the C-4 forms, that his patient was “working” within the meaning of question 7 on the form, and not “totally disabled” within the meaning of question 8 on the form. In so falsifying the C-4 forms, and filing said forms with the Board, defendant offered false instruments for filing in the second degree and committed insurance fraud in the fifth degree and petit larceny.”

Key Takeaway

The Palmeri case highlights the serious consequences medical providers face when they knowingly submit false information on no-fault insurance forms. Courts will uphold fraud convictions when witness testimony consistently demonstrates that a physician deliberately misrepresented a patient’s work capacity, emphasizing that knowledge is quite a broad term in insurance fraud prosecutions.


Legal Update (February 2026): Since this post’s publication, New York’s no-fault insurance regulations, fraud investigation procedures, and penalty structures for healthcare provider violations may have undergone significant amendments. Practitioners should verify current Insurance Law provisions, updated C-4 form requirements, and any revised fraud enforcement protocols that may affect liability and penalties for medical providers in the no-fault system.

Legal Context

Why This Matters for Your Case

New York's no-fault insurance system, established under Insurance Law Article 51, is one of the most complex insurance frameworks in the country. Every motorist must carry Personal Injury Protection coverage that pays medical expenses and lost wages regardless of fault, up to $50,000 per person.

But insurers routinely deny valid claims using peer reviews, EUO scheduling tactics, fee schedule reductions, and coverage defenses. The Law Office of Jason Tenenbaum has handled over 100,000 no-fault cases since 2002 — from initial claim submissions through arbitration before the American Arbitration Association, trials in Civil Court and Supreme Court, and appeals to the Appellate Term and Appellate Division. Jason Tenenbaum is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.

His 2,353+ published legal articles on no-fault practice are cited by attorneys throughout New York. Whether you are dealing with a medical necessity denial, an EUO no-show defense, a fee schedule dispute, or a coverage question, this article provides the kind of detailed case-law analysis that helps practitioners and claimants understand exactly where the law stands.

About This Topic

New York No-Fault Insurance Law

New York's no-fault insurance system requires every driver to carry Personal Injury Protection (PIP) coverage that pays medical expenses and lost wages regardless of who caused the accident. But insurers routinely deny, delay, and underpay valid claims — using peer reviews, IME no-shows, and fee schedule defenses to avoid paying providers and injured claimants. Attorney Jason Tenenbaum has litigated thousands of no-fault arbitrations and court cases since 2002.

271 published articles in No-Fault

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Common Questions

Frequently Asked Questions

What is New York's no-fault insurance system?

New York's no-fault insurance system, codified in Insurance Law Article 51, requires all drivers to carry Personal Injury Protection (PIP) coverage. This pays for medical expenses, lost wages (up to $2,000/month), and other basic economic loss regardless of who caused the accident, up to $50,000 per person. However, to sue for pain and suffering, you must meet the 'serious injury' threshold under Insurance Law §5102(d).

How do I fight a no-fault insurance claim denial?

When a no-fault claim is denied, you can challenge it through mandatory arbitration under the American Arbitration Association's no-fault rules, or by filing a lawsuit in court. Common defenses to denials include challenging the timeliness of the denial, the adequacy of the peer review report, or the insurer's compliance with regulatory requirements. An experienced no-fault attorney can evaluate which strategy gives you the best chance of overturning the denial.

What is the deadline to file a no-fault claim in New York?

Under 11 NYCRR §65-1.1, you must submit a no-fault application (NF-2 form) within 30 days of the accident. Medical providers must submit claims within 45 days of treatment. Missing these deadlines can result in claim denial, though there are limited exceptions for late notice if the claimant can demonstrate a reasonable justification.

What no-fault benefits am I entitled to after a car accident in New York?

Under Insurance Law §5102(b), no-fault PIP covers necessary medical expenses, 80% of lost earnings up to $2,000/month, up to $25/day for other reasonable expenses, and a $2,000 death benefit. These benefits are available regardless of fault, up to the $50,000 policy limit. Claims are paid by your own insurer — not the at-fault driver's.

Can I choose my own doctor for no-fault treatment in New York?

Yes. Under New York's no-fault regulations, you have the right to choose your own physician, chiropractor, physical therapist, or other licensed healthcare provider. The insurer cannot dictate which providers you see. However, the insurer can request an IME with their chosen doctor and may challenge the medical necessity of your treatment through peer review.

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Attorney Jason Tenenbaum

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.

24+ years in practice 1,000+ appeals written 100K+ no-fault cases $100M+ recovered

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 no-fault 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.

Filed under: No-Fault
Jason Tenenbaum, Personal Injury Attorney serving Long Island, Nassau County and Suffolk County

About the Author

Jason Tenenbaum

Jason Tenenbaum is a personal injury attorney serving Long Island, Nassau & Suffolk Counties, and New York City. Admitted to practice in NY, NJ, FL, TX, GA, MI, and Federal courts, Jason is one of the few attorneys who writes his own appeals and tries his own cases. Since 2002, he has authored over 2,353 articles on no-fault insurance law, personal injury, and employment law — a resource other attorneys rely on to stay current on New York appellate decisions.

Education
Syracuse University College of Law
Experience
24+ Years
Articles
2,353+ Published
Licensed In
7 States + Federal

Discussion

Comments (12)

Archived from the original blog discussion.

RZ
Ray Zuppa
Now J.T. you can attest to the fact that I am very busy. So the much heralded return of Zuppa’s Pit has not yet occurred. But I am only 6 months late which is timely for me. And I will have a live video show — each episode will be saved — called “The Truth Hurts.” We broadcast from down town Fallujah — where the America we know fell. And based upon what you just did can you guess the subject of the first show — insurer fraud maybe? From Katrina right on down the road to some things only I know — right now that is. The Zuppa tell all. Between you and I maybe people will get the whole story and we can expose all the fraud. And the reference to Italians was insulting. My people did not engage in the stupidity that was the subject of the Southern District Indictments.
KL
Kurt Lundgren
Talk about the Class Action of Edward Schappell DC v GEICO in the Court of Common Pleas in PA.
AK
Alan Klaus
Fraud runs both ways but money and lobbying protects one side. Just saying.
AK
Alan Klaus
U tell em Kurt. No interest paid for delay of payments over 30 days. Bad insurance Co. There r a number of other situations I can mention but they r trade secrets. 🙂
KL
Kurt Lundgren
Alan, go on Zuppa’s new internet program. It should be taped for You Tube. Every week he interviews someone and reveals secrets of the insurance companies that no one knows about. The program will be mixed with no fault humor, an expose on insurance company misdeeds, MMA fighting, and nude women. Okay, scantily clad women. One doesnt want to offend.
RZ
ray zuppa
Love it Kurt. You are now my producer. Alan you can be my reporter at large. Scanty dress is cool as long as we have scantly dressed men too. You have to be neutral. And each month we have a feature MMA bout between Zuppa and whatever SIU guy wants to take me on. We have to fight in Jersey to be legal. I have a place … a nice gym. We’ll film the episode from the gym.
TL
trial lawyer
Why is it “bad” for Plaintiff attorneys when criminals go to jail?
LR
Larry Rogak
I’m still writing “No Fault! The Musical.” It will appear on Broadway. Not in a theatre — just on Broadway. The one in Brooklyn.
JT
Jason Tenenbaum Author
LOL! i can only imagine ray on a web video telling viewers that hes high on “ray zuppa”, is empowered by drinking tiger blood, is an attorney “warlock”, complaining about “trolls” at insurance companies, and of course…. is WINNING!!!! ray we love you i will def watch your show
KL
Kurt Lundgren
Ray, first episode. Already have commitments from the GEICO Gecko, that Allstate Mayham guy, that actor from The Unit that does the Allstate commercials and State Farms’ entire SIU division. You discuss the proposed new no-fault regs, do commercials courtesy of the Rogak Report, and you take on all in MMA action. Yes, in New Jersey, near a landfill preferably. You are out numbered but then again, you are “The Zuppa”. Kinda like Leonidas at the Battle of Thermopylae. Winner gets the insurance company of their choice, or provider, a prima facie stip for life, a Jason Tennenbaum autographed copy of a DJ motion (personalized with picture of Jason with his arm around the winner, frame and all), a membership (honorary only) from the NCIB with a windshield decal, and a free trip to Flatbush Avenue (round trip subway tokens and Russian/English Dictionary included). The video … its going viral.
RZ
Ray Zuppa
Anon. I love the material but we have to find something I win at. Maybe I can play a basketball game against some 8 year olds — half court — and I could manage to win that; if we keep it under 60 seconds Kurt — the only wise decision I ever made was making you my producer. Rogak: Do I have a role in the play. I can’t sing but I can play guitar — or maybe you’ll just see me there playing guitar with my upside down hat on the ground looking for hand outs anyway.l
SB
square badge square pants
Which attorney next will earn the moniker of “consigliere”? Pretty sad really that the once respected mantle of “consigliere” has been reduced to apply to incompetent money launders with an Esq. degree. Almost as sad as the bastardization of “mafia” in application to any illiterate puffed-up Russian alien with a pile of NF-3’s on his desk.

Legal Resources

Understanding New York No-Fault Law

New York has a unique legal landscape that affects how no-fault cases are litigated and resolved. The state's court system includes the Civil Court (for claims up to $25,000), the Supreme Court (the primary trial court for unlimited jurisdiction), the Appellate Term (which hears appeals from lower courts), the Appellate Division (divided into four Departments, with the Second Department covering Long Island, Brooklyn, Queens, Staten Island, and several upstate counties), and the Court of Appeals (the state's highest court). Each court has its own procedural requirements, local rules, and case-assignment practices that can significantly impact the outcome of your case.

For no-fault matters on Long Island, cases are typically filed in Nassau County Supreme Court (at the courthouse in Mineola) or Suffolk County Supreme Court (in Riverhead). No-fault arbitrations are heard through the American Arbitration Association, which assigns arbitrators throughout the metropolitan area. Workers' compensation claims go to the Workers' Compensation Board, with hearings at district offices across the state. Understanding which forum is appropriate for your case — and the specific procedural rules that apply — is essential for a successful outcome.

The procedural landscape in New York also includes important timing requirements that can affect your case. Most civil actions are subject to statutes of limitations ranging from one year (for intentional torts and claims against municipalities) to six years (for contract actions). Personal injury cases generally have a three-year deadline under CPLR 214(5), while medical malpractice claims must be filed within two and a half years under CPLR 214-a. No-fault insurance claims have their own regulatory deadlines, including 30-day filing requirements for applications and 45-day deadlines for provider claims. Understanding and complying with these deadlines is critical — missing a filing deadline can permanently bar your claim, regardless of how strong your case may be on the merits.

Attorney Jason Tenenbaum regularly practices in all of these venues. His office at 326 Walt Whitman Road, Suite C, Huntington Station, NY 11746, is centrally located on Long Island, providing convenient access to courts and offices throughout Nassau County, Suffolk County, and New York City. Whether you need representation in a no-fault arbitration, a personal injury trial, an employment discrimination hearing, or an appeal to the Appellate Division, the Law Office of Jason Tenenbaum, P.C. brings $24+ years of real courtroom experience to your case. If you have questions about the legal issues discussed in this article, call (516) 750-0595 for a free, no-obligation consultation.

New York's substantive law also presents distinct challenges. In motor vehicle cases, the no-fault system under Insurance Law Article 51 provides first-party benefits regardless of fault, but limits the right to sue for non-economic damages unless the plaintiff establishes a "serious injury" under one of nine statutory categories. This threshold — codified at Insurance Law Section 5102(d) — requires medical evidence showing more than a minor or subjective injury, and courts have developed detailed standards for each category. Fractures must be documented through imaging studies. Claims of permanent consequential limitation or significant limitation of use require quantified range-of-motion testing with comparison to norms. The 90/180-day category demands proof that the plaintiff was unable to perform substantially all of their usual daily activities for at least 90 of the 180 days following the accident.

In employment discrimination cases, the legal standards vary depending on whether the claim arises under state or local law. The New York State Human Rights Law employs a burden-shifting framework: the plaintiff must first establish a prima facie case by showing membership in a protected class, qualification for the position, an adverse employment action, and circumstances giving rise to an inference of discrimination. The burden then shifts to the employer to articulate a legitimate, non-discriminatory reason for its decision. If the employer meets this burden, the plaintiff must demonstrate that the stated reason is pretextual. The New York City Human Rights Law, by contrast, applies a broader standard, asking whether the plaintiff was treated less well than other employees because of a protected characteristic.

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