Key Takeaway
Easy Care v MVAIC: the 2016 split over fee reductions and exhaustion evidence, plus later guidance on verified claims and payment priority.
This article is part of our ongoing coverage coverage, with 267 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.
Easy Care left factual disputes over fee maximums and prior payments. It did not establish that one incorrect payment automatically defeats an exhaustion defense.
Historical note: Alleviation v Allstate (2021) later addressed verified claims, payment priority and missing claim records in a court action; the 2026 exhaustion guide covers the separate patient-facing coverage questions.
Last reviewed: September 2026. Original publication date retained.
The payment record still needed examination
Easy Care Acupuncture v MVAIC, 2016 NY Slip Op 51556(U) reinstated the complaint and remanded the provider’s discovery motion. Some acupuncture payments were proper; other claims raised unresolved questions about code maximums and payments to another provider. A late denial did not preclude asserting exhaustion, but that did not prove exhaustion.
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The old page also said New York had no clear payment-priority regulation. That is incorrect. In Alleviation v Allstate, 191 AD3d 934 (2021), the Second Department discussed verified claims under 11 NYCRR 65-3.15 and rejected a motion lacking claim-specific supporting records.
These were court actions. Do not transfer their procedural results to an arbitration without checking the authority for that forum. A file review should compare the verification history, denial, coverage limit and payments actually relied on. A totals-only ledger may leave the reason for nonpayment unanswered.
Historical commentary from the archive
Jason’s short reaction captures the question the incomplete motion record left open:
Starting backwards, the court questioned the priority of payment regimen. Second, the Court found issues of fact as to the fee schedule reductions. What really happened here?
Connect to the Encyclopedia
- Fee-schedule defense hub: cases, proof and later developments
- Bronx Acupuncture: by-report verification and the motion result
- Forrest Chen: comparison rates and the unpreserved argument
- 2 & 9 Acupuncture: the unresolved 97026 and 97016 claims
- Compas Medical: payment proof versus a suspected code substitution
- 2026 guide: checking the exhaustion ledger and other coverage
For review of a particular no-fault billing dispute, contact our office.
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.
267 published articles in Coverage
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Apr 24, 2019Frequently Asked Questions
Common Questions About This Topic
4 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
What did the court rule in Easy Care Acupuncture v MVAIC?
The complaint was reinstated and the discovery motion remanded for consideration. Some acupuncture payments were proper, but disputes over code maximums and payments to another provider prevented summary dismissal.
Can an insurer assert policy exhaustion even after missing the 30-day denial deadline?
Easy Care expressly allowed an exhaustion defense despite a late denial. That did not establish that MVAIC had proved exhaustion on the record before the court.
What is the workers compensation fee schedule for acupuncture in no-fault cases?
Identify the schedule applicable to the service date and provider category. The older acupuncture-rate decisions cannot replace the later schedule and effective-date rules described by DFS.
How can medical providers challenge a policy exhaustion denial on Long Island?
Compare the claim's verification and denial records with the payment history. A discrepancy needs examination, but Easy Care did not hold that any single erroneous payment defeats the entire defense.
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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.
