Key Takeaway
Urban Radiology v GEICO: Assignment of benefits not required for prima facie case in first-party no-fault actions. Court clarifies trial vs summary judgment standards.
This article is part of our ongoing assignment of benefits coverage, with 105 published articles analyzing assignment of benefits 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.
Urban Radiology, P.C. v GEICO Gen. Ins. Co., 2013 NY Slip Op 50850(U)(App. Term 2d Dept. 2013)
(1) Law requiring AOB
“The Civil Court dismissed the complaint, finding that plaintiff had not established a prima facie case because it had not offered into evidence an assignment of benefits.
While the claim forms at issue did not contain any language regarding an assignment of benefits, there is nothing in the record to indicate that defendant timely objected to the completeness of the forms or sought verification of the existence of a valid assignment. Accordingly, defendant waived any defense based thereon (see Hospital for Joint Diseases v Travelers Prop. Cas. Ins. Co., 9 NY3d 312, 320 ; Hospital for Joint Diseases v Allstate Ins. [*2]Co., 21 AD3d 348 ).”
(2) What is a prima facie case
“Contrary to defendant’s contention, at a trial, unlike upon a provider’s motion for summary judgment, a provider is not required to “show that there is no defense to the cause of action or that the cause of action or defense has no merit” (CPLR 3212 ). Rather, it is defendant’s burden to show that it has a meritorious defense (see generally Seaboard Sur. Co. v Gillette Co., 64 NY2d 304 ; Northrup v Blue Cross & Blue Shield of Utica-Waterdown, 235 AD2d 1022 ; 70 NY Jur 2d, Insurance § 1493) and that such a defense is not precluded (see Presbyterian Hosp. in City of NY v Maryland Cas. Co., 90 NY2d 274, 282 ).”
Considering that the validity of an AOB is a defense, in both no-fault and non-no-fault litigation, this makes sense. The prima facie rule is weird. It promotes more trials where traditional Mary Immaculate and Dan Medical would control over Avenue T v. Auto One. I think the Court is probably stretching 3212(b) if it really believes that submission of a bill is sufficient for purposes of trial but not for summary disposition.
Related Articles
- Motion seeking leave to amend the answer to seek affirmative defense of lack of standing is proper
- Standing in a direct first party case is waivable
- Proving standing without an assignment?
- Assignment valid during unresolved lawsuit
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2013 decision, New York’s no-fault regulations have undergone multiple amendments, including updates to claim form requirements, assignment of benefits procedures, and waiver provisions. Additionally, appellate courts have issued subsequent decisions that may have refined the standards for establishing prima facie cases in assigned first-party actions. Practitioners should verify current regulatory provisions and case law developments when relying on the assignment and waiver principles discussed in this post.
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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Oct 6, 2010Common Questions
Frequently Asked Questions
What is an assignment of benefits in no-fault insurance?
An assignment of benefits (AOB) is a document signed by the injured person transferring their right to receive no-fault insurance payments directly to a healthcare provider. This allows the provider to bill and collect from the insurer without the patient acting as intermediary.
Can an assignment of benefits be challenged?
Yes. Insurers frequently challenge the validity of assignments, arguing they were improperly executed, signed after treatment, or part of a fraudulent scheme. A defective or missing assignment can deprive the provider of standing to pursue benefits directly.
What makes an assignment of benefits valid in New York?
A valid AOB must be signed by the injured person, identify the provider, and be executed contemporaneously with or prior to treatment. It should be on the NF-AOB form or contain equivalent information. Courts scrutinize assignments carefully in no-fault litigation.
What does 'prima facie case' mean in no-fault litigation?
In no-fault litigation, the provider or claimant bears the initial burden of establishing a prima facie case by submitting proof of the claim — including evidence that the services were provided, the claim was timely submitted, and the amount billed is correct. Once the prima facie case is established, the burden shifts to the insurer to demonstrate a valid defense, such as medical necessity denial, lack of coverage, or failure to appear for an EUO or IME.
What does "standing" mean in a no-fault insurance case?
Standing refers to a party's legal right to bring a claim. In no-fault litigation, the medical provider must demonstrate a valid assignment of benefits from the patient to have standing to sue the insurer directly. Without a proper assignment, the provider lacks standing and the case may be dismissed.
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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 assignment of benefits 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.