Key Takeaway
Three 2016 no-fault insurance cases demonstrate how procedural requirements under 11 NYCRR 65-3.5 can derail declaratory judgment actions seeking coverage denials.
This article is part of our ongoing declaratory judgment action coverage, with 56 published articles analyzing declaratory judgment action 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 carriers frequently seek declaratory judgment actions to establish their right to deny claims based on alleged non-compliance with policy conditions. However, these cases must navigate strict procedural requirements under New York’s no-fault regulations, particularly 11 NYCRR 65-3.5, which governs the timing and scheduling of Independent Medical Examinations (IMEs) and Examinations Under Oath (EUOs).
The regulatory framework became more stringent following landmark cases like Longevity and Tam Medical Supply, which established specific factors courts must consider when evaluating whether an insurance carrier has properly scheduled these examinations. Under these precedents, carriers must demonstrate they scheduled IMEs and EUOs promptly upon receiving notice of the loss. Failure to meet these procedural requirements can be fatal to a carrier’s case, even when substantive grounds for denial may exist.
The three cases examined below illustrate a troubling pattern for insurance carriers: even when they believe they have grounds for coverage denial, procedural missteps can result in their motions being struck before reaching the merits.
Jason Tenenbaum’s Analysis:
Country-Wide Ins. Co. v Castro, 2016 NY Slip Op 31505(U)(Sup. Ct. NY CO. 2016)
American Tr. Ins. Co. v Tavarez, 2016 NY Slip Op 31601(U)(Sup. Ct. NY CO. 2016)
American Tr. Ins. Co. v Garcia, 2016 NY Slip Op 31602(U)(Sup. Ct. NY CO. 2016)
All of these no-show default motions were struck by 11 NYCRR 65-3.5(d) or 65-3.5(b), 65-3.6(b). Under the post Longevity and Tam Medical Supply cases, DJs involving IMEs and EUOs that are not scheduled upon receipt of the notice of the loss will rarely achieve the goal that is sought through a DJ, absent perjury.
Key Takeaway
These cases demonstrate that procedural compliance under 11 NYCRR 65-3.5 is crucial for insurance carriers pursuing declaratory judgment actions. The post-Longevity legal landscape requires carriers to schedule IMEs and EUOs immediately upon receiving loss notice. Even when carriers have strong substantive arguments for denial, failure to meet these timing requirements will likely result in unsuccessful declaratory judgment actions, regardless of the quality of their legal papers.
Legal Update (February 2026): The no-fault regulatory framework governing declaratory judgment actions has undergone significant revisions since 2016, including amendments to 11 NYCRR 65-3.5 and 65-3.6 regarding IME and EUO scheduling requirements. Additionally, fee schedules and procedural timelines have been updated multiple times. Practitioners should verify current provisions of Part 65-3 and review recent appellate decisions that may have modified the Longevity and Tam Medical Supply precedents discussed in this analysis.
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
Declaratory Judgment Actions in Insurance Law
Declaratory judgment actions under CPLR 3001 allow insurers and claimants to obtain a judicial determination of their rights under an insurance policy before or during the course of litigation. In the no-fault context, carriers frequently seek declaratory judgments on coverage, fraud, and policy procurement issues. These articles analyze the procedural requirements, strategic considerations, and substantive standards governing declaratory judgment practice in New York insurance disputes.
56 published articles in Declaratory Judgment Action
Keep Reading
More Declaratory Judgment Action Analysis
Post Jamaica Wellness Appellate Division victories
Jamaica Wellness Appellate Division victories: Fourth Department clarifies successive summary judgment motions in no-fault insurance cases following prior appeal decisions.
Feb 8, 2020Non contact case
New York appellate court reverses denial of summary judgment in no-fault insurance declaratory judgment action, finding motion not premature despite discovery issues.
Oct 17, 2019Notice of Entry
New York court ruling on Notice of Entry requirements in foreclosure and declaratory judgment actions, including implications for no-fault insurance cases.
May 19, 2017Judicial notice of the Supreme Court file
New York Appellate Term explores judicial notice boundaries in res judicata case, examining when courts "may" take notice of Supreme Court records without party request.
Mar 21, 2016Another IME no-show victory shrowded in American Transit citations
Court victory for insurer after patient's IME no-show, featuring American Transit citations and analysis of denial rights in New York no-fault cases.
Jun 4, 2014Negligent Employment in Insurance: When Companies Cross the Line from Claims Handling to Harmful Practices
Learn when insurance company practices constitute negligent employment. Expert analysis of Walden Bailey decision and claims handling misconduct. Call 516-750-0595.
Jul 6, 2019Common Questions
Frequently Asked Questions
What is a declaratory judgment action in insurance litigation?
A declaratory judgment action under CPLR 3001 asks the court to determine the rights and obligations of the parties under an insurance policy. In no-fault practice, insurers frequently file declaratory judgment actions to establish that they have no obligation to pay claims — for example, by seeking a declaration that the policy is void due to fraud or material misrepresentation on the application. Defendants can cross-move for summary judgment or raise counterclaims for the unpaid benefits.
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 declaratory judgment action 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.