Key Takeaway
Easy Care Acupuncture v MVAIC case shows conclusory non-receipt statements insufficient to dismiss 45-day no-fault billing cases without proper search evidence
Easy Care Acupuncture PC v MVAIC, 2014 NY Slip Op 51645(U)(App. Term 1st Dept. 2014)
“The action, seeking recovery of assigned first-party no-fault benefits, is not ripe for summary dismissal. The vague and conclusory assertion by defendant MVAIC’s claim representative that defendant “was not aware of plaintiff’s bills” prior to the commencement of the action was insufficient, on this record, to make a prima facie showing that plaintiff’s claims were untimely submitted beyond the applicable 45-day time limit (see 11 NYCRR 65-1.1; cf. NY Arthroscopy & Sports Medicine PLLC v Motor Veh. Acc. Indem. Corp., 15 Misc 3d 89 ). Conspicuously absent from the claim’s representative’s moving affidavit was any indication that she or a colleague searched the assignor’s file — said to be under the affiant’s “custody and control” — to ascertain whether plaintiff’s bills and claims had been logged in by defendant as received.”
Like any other defense that germinates from a “non-receipt” of a item, the Courts have uniformly held that some type of search was made prior coming to the conclusion that an item was not received. The search does not need to be exhaustive (a prior case from the second department dispelled this notion), but the search must be somewhat detailed. Here, all that was presented was a boilerplate I did not receive the billing. That is not enough to win in this Court.
Related Articles
- TImely submissions and MVAIC – a real problem
- 45-days…and then what?
- The Provider is Under an Extremely Tight Leash to Explain Why a Bill Was Untimely Submitted: Essential Guide for Long Island and NYC Healthcare Providers
- The Court of Appeals discusses a condition precedent
Legal Update (February 2026): Since this 2014 decision, practitioners should verify current provisions of 11 NYCRR 65-1.1 regarding timely submission requirements, as no-fault regulations and procedural standards for establishing non-receipt defenses may have been amended. Additionally, evolving case law may have further refined the evidentiary standards required to demonstrate adequate searches of claim files when asserting non-receipt.
