Key Takeaway
Five Boro Psychological Services loses another appeal due to insufficient evidence in their motion for summary judgment, highlighting the importance of proper documentation in no-fault cases.
The Appellate Term continues to scrutinize healthcare providers who fail to meet basic evidentiary requirements in no-fault insurance cases. Five Boro Psychological Services has once again found themselves on the losing end of an appeal, earning them another dubious honor in what has become a pattern of unsuccessful litigation attempts.
This case demonstrates a fundamental issue plaguing many no-fault providers: the failure to submit adequate supporting documentation when seeking summary judgment. The court’s decision reinforces established precedent regarding CPLR 4518 and the stringent requirements for business record affidavits in medical billing disputes.
Jason Tenenbaum’s Analysis:
Five Boro Psychological Servs., P.C. v MVAIC, 2012 NY Slip Op 50677(U)(App. Term 2d. Dept. 2012)
The Mr. Five Boro award now goes to……Mr. Five Boro.
“The affidavit submitted by plaintiff’s billing and collection supervisor in support of plaintiff’s motion for summary judgment was insufficient to establish plaintiff’s prima facie case (see CPLR 4518 ; Art of Healing Medicine, P.C. v Travelers Home & Mar. Ins. Co., 55 AD3d 644 ; Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128, 2011 NY Slip Op 51292 ). Accordingly, plaintiff’s motion for summary judgment was properly denied.”
Do you think if Mr. Five Boro had to pay $2,300 (the average cost of a record on appeal if given to a printer to do) instead of proceeding in the original record, he would have perfected such a meritorious appeal?
Key Takeaway
Healthcare providers must ensure their billing supervisors submit comprehensive affidavits that comply with CPLR 4518 requirements. This case serves as another reminder that inadequate documentation continues to undermine otherwise valid claims, and providers should carefully review their evidence before pursuing costly appeals that lack merit from the outset.
Related Articles
- When Progressive’s procedural failures demonstrate common insurance defense mistakes
- Mr. Five Boro’s continued pattern of inadequate documentation
- How acupuncture providers face similar evidentiary challenges
- Understanding res judicata principles in no-fault litigation
- Default judgment consequences for inadequate submissions
Legal Update (February 2026): Since this 2012 post, New York’s no-fault insurance regulations have undergone several amendments, including updates to fee schedules, documentation requirements, and procedural standards for healthcare provider claims. Additionally, appellate courts have issued numerous decisions that may have refined or expanded upon the CPLR 4518 business records requirements discussed here. Practitioners should verify current regulatory provisions and recent case law developments when handling similar no-fault billing disputes.
