Key Takeaway
Court dismisses no-fault case when healthcare provider sued wrong insurance carrier, highlighting importance of proper defendant identification in insurance claims.
This article is part of our ongoing coverage coverage, with 149 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.
Suing the Wrong Insurance Carrier: A Costly Mistake in No-Fault Cases
Healthcare providers pursuing no-fault insurance benefits must ensure they’re suing the correct insurance carrier. The consequences of naming the wrong defendant can be severe, as demonstrated in a recent Appellate Term decision that granted summary judgment dismissing a provider’s entire case simply because they sued the wrong insurer.
This scenario is more common than one might expect in New York no-fault insurance law. When multiple insurance companies are involved in coverage disputes, or when policies are transferred between carriers, providers can easily target the wrong defendant. The court’s analysis in Flatbush Chiropractic shows how insurance companies can successfully defend these cases by providing clear documentation of their lack of coverage.
Jason Tenenbaum’s Analysis:
Flatbush Chiropractic, P.C. v Omni Indem. Co., 2014 NY Slip Op 51235(U)(App. Term 2d Dept. 2014)
“In support of its motion, defendant submitted affidavits by its litigation manager and by a manager of American Independent Insurance Company (AIIC), which affidavits sufficiently established defendant’s lack of coverage defense (see Great Health Care Chiropractic, P.C. v Omni Indem. Co., 40 Misc 3d 139, 2013 NY Slip Op 51450 ; Astoria Quality Med. Supply v State Farm Mut. Auto. Ins. Co., 31 Misc 3d 138, 2011 NY Slip Op 50743 ). Notably, the AIIC manager attested that her company had issued the policy covering the accident in question. Consequently, as defendant demonstrated that plaintiff had sued the wrong insurance carrier, defendant was entitled to summary judgment dismissing the complaint (see Vincent Med. Servs., P.C. v Omni Indem. Co., 42 Misc 3d 142, 2014 NY Slip Op 50224 ).”
*Why didn’t the Appellate Term file an order to show cause and sanction Rybak and his appellate writer? These appeals bespeak frivolity and contribute to the 2.5 year wait that all of us must endure on the appeals.
Key Takeaway
When insurance companies can prove through affidavits that they lack coverage for a particular claim, courts will grant summary judgment dismissing the case. This decision reinforces the importance of thorough investigation before filing suit, as defending these coverage disputes requires clear documentation from the actual insurer.
Legal Update (February 2026): Since this 2014 post, New York’s no-fault insurance regulations and procedural requirements for carrier identification may have been updated through amendments to 11 NYCRR Part 65 or changes in case law regarding proper defendant identification. Healthcare providers should verify current provisions regarding carrier verification procedures and any new requirements for confirming coverage before initiating litigation against insurance companies.
Related Articles
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.
149 published articles in Coverage
Keep Reading
More Coverage Analysis
IME no-show is a policy defense triggering the hourly attorney fee provision
Learn how IME no-show defenses trigger hourly attorney fee provisions in NY no-fault insurance. Court rules failure to attend IME is policy defense.
May 22, 2021Contractual deemer
New York courts examine when out-of-state insurers can avoid no-fault coverage obligations through contractual deemer provisions and policy language analysis.
Apr 24, 2021Policy Exhaustion and priority of payment
Learn how New York no-fault insurance policy limits affect medical provider recovery when coverage is exhausted. Mount Sinai Hospital case analysis.
Mar 21, 2013Use and Operation – Should the SUM endorsement be read differently than the no-fault endorsement?
Analysis of use and operation coverage differences between SUM endorsement and no-fault PIP endorsement under New York insurance law.
Jul 26, 2010Workers Comp
Court ruling highlights the intersection between no-fault insurance and workers' compensation, emphasizing that Workers' Compensation Board has primary jurisdiction over...
Jul 24, 2019Parties cannot stipulate away issues of pure coverage
NY Court rules parties cannot stipulate away pure coverage issues in no-fault insurance disputes. Key precedent for coverage defense strategies.
Apr 14, 2015Common Questions
Frequently Asked Questions
What are common coverage defenses in no-fault insurance?
Common coverage defenses include policy voidance due to material misrepresentation on the insurance application, lapse in coverage, the vehicle not being covered under the policy, staged accident allegations, and the applicability of policy exclusions. Coverage issues are often treated as conditions precedent, meaning the insurer bears the burden of proving the defense. Unlike medical necessity denials, coverage defenses go to whether any benefits are owed at all.
What happens if there's no valid insurance policy at the time of the accident?
If there is no valid no-fault policy covering the vehicle, the injured person can file a claim with MVAIC (Motor Vehicle Accident Indemnification Corporation), which serves as a safety net for people injured in accidents involving uninsured vehicles. MVAIC provides the same basic economic loss benefits as a standard no-fault policy, but the application process has strict requirements and deadlines.
What is policy voidance in no-fault insurance?
Policy voidance occurs when an insurer declares that the insurance policy is void ab initio (from the beginning) due to material misrepresentation on the application — such as listing a false garaging address or failing to disclose drivers. Under Insurance Law §3105, the misrepresentation must be material to the risk assumed by the insurer. If the policy is voided, the insurer has no obligation to pay any claims, though the burden of proving the misrepresentation falls on the insurer.
How does priority of coverage work in New York no-fault?
Under 11 NYCRR §65-3.12, no-fault benefits are paid by the insurer of the vehicle the injured person occupied. For pedestrians and non-occupants, the claim is made against the insurer of the vehicle that struck them. If multiple vehicles are involved, regulations establish a hierarchy of coverage. If no coverage is available, the injured person can apply to MVAIC. These priority rules determine which insurer bears financial responsibility and are frequently litigated.
What is SUM coverage in New York?
Supplementary Uninsured/Underinsured Motorist (SUM) coverage, governed by 11 NYCRR §60-2, provides additional protection when the at-fault driver has no insurance or insufficient coverage. SUM allows you to recover damages beyond basic no-fault benefits, up to your policy's SUM limits, when the at-fault driver's liability coverage is inadequate. SUM arbitration is mandatory and governed by the policy terms, and claims must be made within the applicable statute of limitations.
Was this article helpful?
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 coverage 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.