Key Takeaway
Roggio doctrine doesn't apply when assignor executed assignment before arbitrating medical bills - NY no-fault insurance law analysis of provider reimbursement claims.
This article is part of our ongoing procedural issues coverage, with 186 published articles analyzing procedural issues 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.
Dayna Physical Therapy, P.C. v Travelers Ins. Co., 2013 NY Slip Op 50322(U)(App. Term 2d. Dept. 2013)
“In this action by a provider to recover assigned first-party no-fault benefits, defendant moved, pursuant to CPLR 3211 and CPLR 3212, to dismiss the complaint. Defendant contended that, pursuant to Roggio v Nationwide Mut. Ins. Co. (66 NY2d 260 ), plaintiff was precluded from litigating its claims for reimbursement of assigned first-party no-fault benefits since plaintiff’s assignor had, prior to this action, elected to arbitrate claims for no-fault benefits which he had not assigned and which arose out of the same accident as was involved in the instant action”
…
“The Civil Court properly denied defendant’s motion. As the Civil Court correctly noted, since plaintiff’s assignor had executed the assignment of benefits to plaintiff prior to his commencement of his own arbitration, the holding in Roggio (66 NY2d 260) does not apply here and, thus, plaintiff was not precluded from litigating the claims at issue in this action”
Roggio appears to be strictly construed to a prior election that a real plaintiff makes in adjudicating outstanding no-fault billing. Yet, an EIP who arbitrates bills and loses can collaterally estop his assignee in a future litigation or arbitration. Triboro Quality Med. Supply, Inc. v State Farm Mut. Auto. Ins. Co.,36 Misc.3d 131(A)(App. Term 1st Dept. 2012)
Related Articles
- Understanding collateral estoppel in New York no-fault insurance cases
- Combating litigation delay tactics in New York no-fault insurance cases
- Single motion rule and statute of limitations considerations
- CPLR 2106 procedural requirements for medical practice owners
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2013 post, New York’s no-fault arbitration procedures and assignment of benefits regulations may have been modified through regulatory amendments or updated fee schedules. Practitioners should verify current provisions regarding the timing of assignments relative to arbitration elections and any changes to the Roggio doctrine’s application in provider reimbursement cases.
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.
About This Topic
Procedural Issues in New York Litigation
New York civil procedure governs every stage of litigation — from pleading requirements and service of process to motion practice, discovery deadlines, and trial procedures. The CPLR creates strict procedural rules that can make or break a case regardless of the underlying merits. These articles examine the procedural pitfalls, timing requirements, and strategic considerations that practitioners face in New York state courts, with a particular focus on no-fault insurance and personal injury practice.
186 published articles in Procedural Issues
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Frequently Asked Questions
What are common procedural defenses in New York no-fault litigation?
Common procedural defenses include untimely denial of claims (insurers must issue denials within 30 days under 11 NYCRR §65-3.8(c)), failure to properly schedule EUOs or IMEs, defective service of process, and failure to comply with verification request requirements. Procedural compliance is critical because courts strictly enforce these requirements, and a single procedural misstep by the insurer can result in the denial being overturned.
What is the CPLR and how does it affect my case?
The New York Civil Practice Law and Rules (CPLR) is the primary procedural statute governing civil litigation in New York state courts. It covers everything from service of process (CPLR 308) and motion practice (CPLR 2214) to discovery (CPLR 3101-3140), statute of limitations (CPLR 213-214), and judgments. Understanding and complying with CPLR requirements is essential for successful litigation.
What is the 30-day rule for no-fault claim denials?
Under 11 NYCRR §65-3.8(c), an insurer must pay or deny a no-fault claim within 30 calendar days of receiving proof of claim — or within 30 days of receiving requested verification. Failure to issue a timely denial precludes the insurer from asserting most defenses, including lack of medical necessity. This 30-day rule is strictly enforced by New York courts and is a critical defense for providers and claimants.
How does improper service of process affect a no-fault lawsuit?
Improper service under CPLR 308 can result in dismissal of a case for lack of personal jurisdiction. In no-fault collection actions, proper service on insurers typically requires serving the Superintendent of Financial Services under Insurance Law §1212. If service is defective, the defendant can move to dismiss under CPLR 3211(a)(8), and any default judgment obtained on defective service may be vacated.
What is a condition precedent in no-fault insurance?
A condition precedent is a requirement that must be satisfied before a party's obligation arises. In no-fault practice, claimant conditions precedent include timely filing claims, appearing for EUOs and IMEs, and responding to verification requests. Insurer conditions precedent include timely denying claims and properly scheduling examinations. Failure to satisfy a condition precedent can be dispositive — an untimely denial waives the insurer's right to contest the claim.
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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 procedural issues 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.