Key Takeaway
Court finds triable issue of fact exists when insurance company claims non-receipt of claim form but provider has proof of mailing. Untimely submission alone doesn't warrant dismissal.
This article is part of our ongoing non receipt of bill coverage, with 12 published articles analyzing non receipt of bill 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.
No-fault insurance disputes often center on whether required documentation was properly submitted to insurance carriers. When carriers claim they never received claim forms, the burden shifts between parties depending on the evidence presented. The case of Lenox Hill Radiology v Great Northern Insurance Co. illustrates how courts handle these non receipt scenarios and why procedural defenses may not always succeed.
This appellate decision demonstrates that insurance companies cannot simply deny receipt without considering contrary evidence from healthcare providers. The court’s analysis reveals important principles about burden of proof and the limitations of certain procedural defenses in no-fault litigation.
Jason Tenenbaum’s Analysis:
Lenox Hill Radiology v Great N. Ins. Co., 2016 NY Slip Op 50206(U)(App. Term 2d Dept. 2016)
(1) “While defendant made a prima facie showing that it had not received plaintiff’s claim form, the affidavit of the mailing supervisor in plaintiff’s attorneys’ offices established that the claim at issue had been mailed to defendant. Thus, a triable issue of fact exists as to the submission of the claim form”
(2) “Moreover, contrary to defendant’s contention, even if plaintiff failed to submit the claim form in a timely manner, untimely submission, in and of itself does not entitle defendant to summary judgment dismissing the complaint”
I am confused as to why this was appealed, or why an insurance carrier paid money to appeal this? Could someone enlighten me here?
Key Takeaway
When insurance carriers claim non-receipt of claim forms, they can establish a prima facie case, but providers can counter with evidence of proper mailing. Courts will find triable issues of fact exist when both sides present credible evidence. Additionally, even late submission alone doesn’t guarantee dismissal of a provider’s complaint, contrary to what some carriers may argue.
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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.
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May 30, 2012Affidavits of Non-Receipt and Default Judgment Procedures in NY Personal Injury Cases
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Jan 9, 2010Mailed to the wrong address – okay
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Jan 25, 2017Common Questions
Frequently Asked Questions
What happens if a no-fault insurer claims it never received the bill?
The provider must prove proper mailing of the claim. Under no-fault regulations, proof of mailing by certified and regular mail creates a presumption of receipt. If the insurer claims non-receipt, the burden shifts to show the claim was never actually mailed or that there was a mail failure.
How do I prove that a no-fault bill was properly mailed?
Maintain proof of mailing through certified mail receipts, return receipts, office mailing procedures affidavits, and contemporaneous mailing logs. Courts accept business practice affidavits from office staff describing standard mailing procedures as evidence of proper mailing.
What is the deadline to submit a no-fault bill to the insurer?
Healthcare providers must submit no-fault bills within 45 days of the date of service under 11 NYCRR §65-1.1. If the insurer claims non-receipt, the provider should re-submit and maintain proof of the original timely mailing to preserve the claim.
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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 non receipt of bill 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.