Key Takeaway
Great Health Care v Hanover: a garaging-fraud defense failed without a timely denial. The provider won summary judgment; Prompt Medical confirms preclusion.
This article is part of our ongoing coverage coverage, with 173 published articles analyzing coverage 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 insurer alleged a false garaging address, but it could not prove a timely denial. In Great Health Care Chiropractic v Hanover, 2014 NY Slip Op 50359(U), the Appellate Term granted the provider summary judgment and denied the insurer’s motion.
Still current (September 2026): Prompt Medical Group v Erie, 2026 NY Slip Op 50796(U), confirms that procurement misrepresentation is subject to a timely denial; Great Health Care’s result was an application of that rule.
Last reviewed: September 2026.
The provider won this appeal
The Appellate Term, Second Department, reversed on February 28, 2014. It denied Hanover’s motion, granted the provider’s summary-judgment motion and sent the case back for calculation of statutory interest and attorney’s fees. The provider had established its own entitlement to judgment. This was more than a ruling that the insurer needed a trial.
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The denial failure mattered twice: Hanover could not use the procurement defense to obtain dismissal or to defeat the provider’s motion. The court relied on Westchester Medical Center v GMAC, 80 AD3d 603 (2011). Describing the alleged fraud as going to the application did not take it outside the denial requirement.
What to compare in a later claim
Prompt Medical involved deficient proof that verification requests and a denial were mailed. It denied the insurer’s motion in full; it did not award the provider judgment. Read each disposition separately. An insurer losing its motion does not always mean the opposing party wins.
For a procurement denial, start with the claim receipt date and the proof supporting any verification toll. Then check the denial’s mailing and stated ground. Materiality is a separate issue; even a timely denial does not establish that the insurer would have refused the policy.
Jason’s 2014 criticism
Jason disagreed with preclusion in this March 2014 comment. It records his position at the time, not an exception recognized in Great Health Care:
Doctrinally, a fraudulent procurement defense should not be bound by the 30-day pay or deny rule. This is so since the Appellate Division in Kaplun specifically held that an insurance carrier can seek recompense from an EIP for monies paid out due to this fraud and, therefore, the defense can be raised at an time. Contrariwise, the Court instructed us in Cornell Medical that an unjust enrichment cannot lie if the defense is precludable. GMAC was an aberrant act and the “preclusion” appeared to be more dicta than anything else.
The argument about recovering earlier payments does not change the result in this claim action. The appellate court applied preclusion, and Prompt Medical applies it again in 2026.
Connect to the Encyclopedia
Start with the fraudulent procurement and material misrepresentation hub, then compare these records:
- Alignment (2020): ownership, use and the underwriting record
- Renelique (March 2016): a factual issue without entitlement to dismissal
- Renelique (November 2016): materiality and competing motion burdens
- Compas (2016): separate claims, tolling and verification responses
- Maxford (2018): materiality and a prior default order
For review of a particular no-fault dispute, contact the firm with the policy, application and claim record.
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
Insurance Coverage Issues in New York
Coverage disputes determine whether an insurance policy provides benefits for a particular claim. In the no-fault context, coverage questions involve policy inception, named insured status, vehicle registration requirements, priority of coverage among multiple insurers, and the applicability of exclusions. These articles examine how New York courts resolve coverage disputes, the burden of proof on coverage defenses, and the interplay between regulatory requirements and policy language.
173 published articles in Coverage
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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.
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