Key Takeaway
Court ruling demonstrates that expert testimony on range of motion limitations and orthopedic tests can establish serious injury threshold under NY Insurance Law 5102(d).
This article is part of our ongoing coverage coverage, with 149 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.
When litigating serious injury claims under New York’s no-fault insurance law, establishing the threshold requirements can be challenging, particularly when facing well-funded defendants. The Motor Vehicle Accident Indemnification Corporation (MVAIC) often aggressively defends even modest policy limits cases, making thorough medical documentation crucial for plaintiffs.
The Cooper v. MVAIC decision provides important guidance on what types of medical evidence can satisfy the “permanent consequential limitation of use” category under Insurance Law Section 5102(d). This case is particularly significant because it involves MVAIC, which serves as the insurer of last resort for uninsured motorist claims and frequently contests serious injury determinations, even in cases with relatively low policy limits.
Jason Tenenbaum’s Analysis:
Cooper v Motor Veh. Acc. Indem. Corp., 2016 NY Slip Op 51707(U)(App. Term 2d Dept. 2016)
“Here, a fair interpretation of the evidence supports the jury’s conclusion that plaintiff sustained a serious injury under the permanent consequential limitation of use category of Insurance Law § 5102 (d). Plaintiff’s expert witness testified about plaintiff’s limitation of her ranges of motion and compared his findings to normal ranges of motion. Moreover, the expert witness offered testimony with respect to the tests he had performed to arrive at his conclusion that plaintiff had sustained a serious injury (see Toure v Avis Rent A Car Sys., 98 NY2d 345 ; Scudera v Mahbubur, 299 AD2d 535 ). Although defendant’s medical experts offered a different opinion, the resolution of conflicting medical opinions is within the province of the jury (see Mendoza v Kaplowitz, 215 AD2d 735 ).”
Range of motion and orthopedic tests are sufficient to establish threshold. Leave it to MVAIC to make plaintiff’s life on a 25k policy case miserable.
Key Takeaway
The Cooper decision confirms that expert medical testimony documenting range of motion limitations and orthopedic test results can establish serious injury under the “permanent consequential limitation of use” category. When medical experts disagree, juries have the authority to weigh conflicting opinions and determine which is more credible.
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- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2016 post, New York’s serious injury threshold requirements under Insurance Law § 5102(d) may have been subject to regulatory amendments, updated medical documentation standards, or evolving case law interpretations. Additionally, MVAIC procedures and defense strategies may have changed through regulatory updates or administrative modifications. Practitioners should verify current threshold requirements and evidentiary standards when pursuing serious injury claims.
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.
149 published articles in Coverage
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Frequently Asked Questions
What are common coverage defenses in no-fault insurance?
Common coverage defenses include policy voidance due to material misrepresentation on the insurance application, lapse in coverage, the vehicle not being covered under the policy, staged accident allegations, and the applicability of policy exclusions. Coverage issues are often treated as conditions precedent, meaning the insurer bears the burden of proving the defense. Unlike medical necessity denials, coverage defenses go to whether any benefits are owed at all.
What happens if there's no valid insurance policy at the time of the accident?
If there is no valid no-fault policy covering the vehicle, the injured person can file a claim with MVAIC (Motor Vehicle Accident Indemnification Corporation), which serves as a safety net for people injured in accidents involving uninsured vehicles. MVAIC provides the same basic economic loss benefits as a standard no-fault policy, but the application process has strict requirements and deadlines.
What is policy voidance in no-fault insurance?
Policy voidance occurs when an insurer declares that the insurance policy is void ab initio (from the beginning) due to material misrepresentation on the application — such as listing a false garaging address or failing to disclose drivers. Under Insurance Law §3105, the misrepresentation must be material to the risk assumed by the insurer. If the policy is voided, the insurer has no obligation to pay any claims, though the burden of proving the misrepresentation falls on the insurer.
How does priority of coverage work in New York no-fault?
Under 11 NYCRR §65-3.12, no-fault benefits are paid by the insurer of the vehicle the injured person occupied. For pedestrians and non-occupants, the claim is made against the insurer of the vehicle that struck them. If multiple vehicles are involved, regulations establish a hierarchy of coverage. If no coverage is available, the injured person can apply to MVAIC. These priority rules determine which insurer bears financial responsibility and are frequently litigated.
What is SUM coverage in New York?
Supplementary Uninsured/Underinsured Motorist (SUM) coverage, governed by 11 NYCRR §60-2, provides additional protection when the at-fault driver has no insurance or insufficient coverage. SUM allows you to recover damages beyond basic no-fault benefits, up to your policy's SUM limits, when the at-fault driver's liability coverage is inadequate. SUM arbitration is mandatory and governed by the policy terms, and claims must be made within the applicable statute of limitations.
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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.
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