Key Takeaway
Court ruling clarifies MVAIC prima facie case requirements, emphasizing medical providers must prove NY residency and notice of intention filing beyond basic claim submission.
This article is part of our ongoing prima facie case coverage, with 73 published articles analyzing prima facie case 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.
Medical providers pursuing Motor Vehicle Accident Indemnification Corporation (MVAIC) claims face specific procedural requirements that extend beyond simply filing paperwork. MVAIC serves as New York’s safety net for victims of uninsured motorist accidents, but obtaining compensation requires meeting precise legal standards. Understanding what constitutes a prima facie case is crucial for medical providers seeking reimbursement for treating accident victims.
The Second Department’s Appellate Term recently clarified these requirements in a decision that highlights common pitfalls in MVAIC litigation. This ruling demonstrates how even seemingly straightforward claims can fail when providers don’t establish all necessary elements of their case.
Jason Tenenbaum’s Analysis:
SK Prime Med. Supply, Inc. v MVAIC, 2015 NY Slip Op 51663(U)(App. Term 2d Dept. 2015)
“Although plaintiff’s witness testified that she had mailed the claim form to MVAIC and that the claim had not been paid, since plaintiff did not establish that plaintiff’s assignor provided MVAIC with proof that the assignor was a resident of the State of New York on the date of the accident and that a notice of intention to make claim form was submitted to MVAIC, plaintiff failed to establish its prima facie case”
The medical provider must also prove that Assignor was a NY resident and that a notice of intention was filed.
Key Takeaway
Simply mailing claim forms and proving non-payment isn’t sufficient for MVAIC cases. Medical providers must demonstrate their assignor’s New York residency status at the time of the accident and confirm proper notice of intention was filed. This decision reinforces that establishing a prima facie case requires meeting all procedural prerequisites, not just basic claim submission requirements.
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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
Prima Facie Case Requirements in New York
Establishing a prima facie case is the threshold burden that every plaintiff or moving party must meet. In no-fault practice, the standards for a prima facie case on summary judgment have been refined through extensive appellate litigation — covering the sufficiency of claim forms, proof of mailing, medical evidence, and the procedural prerequisites for establishing entitlement to benefits. These articles analyze what constitutes a prima facie showing across different claim types and the evidence required to meet or defeat that burden.
73 published articles in Prima Facie case
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More Prima Facie case Analysis
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Jan 8, 2018No Fault and Uninsured Motorist subrogation
Court ruling on no-fault and uninsured motorist subrogation requiring physical examination and prima facie proof of serious injury and medical necessity.
Feb 27, 2012Where you can go wrong on a liability case – an interesting and scary read
A cautionary tale about how failing to establish basic liability elements can lead to directed verdicts and potential malpractice claims in personal injury cases.
Jun 5, 2010Etienne applied differently in First Department
Second Department Appellate Term applies Viviane Etienne precedent differently than First Department, showing varying interpretations of prima facie standards in no-fault cases.
Nov 17, 2015Partial Summary Judgment granted on appeal
NY Appellate Term allows appeals of partial summary judgment orders on prima facie case and timely denials in no-fault insurance litigation.
Oct 27, 2013Common Questions
Frequently Asked Questions
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.
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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 prima facie case 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.