There was no accident

No-fault insurance coverage in New York is predicated on the existence of a qualifying motor vehicle accident. While this seems straightforward, disputes frequently arise about whether an accident actually occurred. Insurance carriers can deny coverage when competent evidence establishes that no accident took place, or that injuries did not arise from a motor vehicle-related incident.

The Pavlova v Allstate case illustrates how insurers can successfully establish a “no accident” defense through examination under oath testimony. When an insured provides sworn testimony definitively stating that no accident occurred, and that testimony is corroborated by a supporting affidavit, carriers can meet their burden of proving that claimed injuries did not arise from a covered event.

This defense requires careful development. The insured’s testimony must be clear, detailed, and internally consistent. Generic denials or equivocal statements will not suffice. Courts scrutinize “no accident” defenses closely because they completely bar recovery, making the quality and specificity of the evidence critical to success.

Case Background

A healthcare provider sought payment for medical services provided to an alleged pedestrian accident victim. Allstate Insurance Company moved for summary judgment, asserting that no qualifying accident had occurred. The carrier submitted the examination under oath transcript of its insured, who testified that she had been parking her vehicle when the incident allegedly happened, that no accident occurred, and that the plaintiff’s assignor (a pedestrian) was not struck by her vehicle.

Allstate also submitted a supporting affidavit from the insured attesting to these same facts. The provider opposed the motion, but failed to raise a triable issue of fact regarding whether an accident occurred. The court needed to determine whether the EUO testimony and affidavit provided sufficient proof to establish the “no accident” defense.

Jason Tenenbaum’s Analysis

Pavlova v Allstate Ins. Co., 2018 NY Slip Op 51061(U)(App. Term 2d Dept. 2018)

“In support of its motion, defendant submitted the transcript of the examination under oath (EUO) of its insured in which she testified that she had been parking her vehicle at the time of the alleged accident, that no accident had occurred and that plaintiff’s assignor, a pedestrian, had not been struck by her vehicle. In a supporting affidavit, the insured attested to the same facts. The EUO testimony and the affidavit are sufficient to demonstrate, prima facie, that “the alleged injury not arise out of an insured incident” (Central Gen. Hosp. v Chubb Group of Ins. Cos., 90 NY2d 195, 199 ; see Andromeda Med. Care, P.C. v NY Cent. Mut. Fire Ins. Co., 26 Misc 3d 126, 2009 NY Slip Op 52601 ; Midwood Med. Equip. & Supply, Inc. v USAA Cas. Ins. Co., 25 Misc 3d 139, 2009 NY Slip Op 52379 ”

I just had a discussion with someone regarding 65-.14, which stands for the proposition that contact is not necessary for no-fault eligibility purposes. The case law has construed that, and properly, to require a discernible nexus between the instrumentality and the injury. (1) Car must it person.; (2) Person in car that stop shorts; (3) Car hits power line that falls on someone. But a pedestrian without contacting a vehicle, or a pedestrian that did not contact an object due to a car’s contact with something will continue to require no-fault ineligibility.

Legal Significance

The Pavlova decision establishes that EUO testimony combined with corroborating affidavits can provide sufficient proof to establish that no qualifying accident occurred. The court’s analysis relies on Central General Hospital v Chubb Group of Insurance Cos., which holds that insurance carriers can deny coverage when competent evidence demonstrates injuries did not arise from an insured incident. Pavlova extends this principle by confirming that the insured’s own testimony denying an accident occurred constitutes competent proof.

This evidentiary framework makes practical sense. The insured was present and has first-hand knowledge of what happened. When that person testifies under oath that no accident occurred, and then reaffirms that testimony in a sworn affidavit, the combination creates strong evidence. The dual submission—both EUO transcript and affidavit—prevents arguments that the insured misspoke or was misunderstood during the examination.

Jason Tenenbaum’s discussion of Insurance Regulation 65-3.14 adds important context. That regulation provides that physical contact between a motor vehicle and the injured person is not required for no-fault eligibility. However, as case law has clarified, there must be a “discernible nexus” between the motor vehicle and the injury. A pedestrian who trips while attempting to avoid a vehicle may have such a nexus. But a pedestrian who claims injury without any interaction with or reaction to a vehicle lacks the required connection.

Practical Implications

For insurance carriers, Pavlova validates the use of EUO testimony to establish “no accident” defenses. When carriers suspect fraudulent claims or believe no covered accident occurred, conducting thorough EUOs becomes critical. The examining attorney should ask specific, detailed questions about what happened, obtaining clear statements about whether an accident occurred and whether the claimant’s vehicle made contact with the alleged victim.

Carriers should also obtain post-EUO affidavits from insureds reaffirming their testimony. The combination of EUO transcript and affidavit provides stronger proof than either alone. If the insured’s testimony seems inconsistent or unclear during the EUO, follow-up questioning or a supplemental affidavit can clarify any ambiguities before the carrier denies the claim.

For healthcare providers and plaintiffs’ attorneys, Pavlova demonstrates the difficulty of overcoming well-documented “no accident” defenses. When carriers present clear EUO testimony and affidavits denying an accident occurred, providers need substantial contradictory evidence to create fact questions. Merely pointing to the provider’s own records stating an accident happened will not suffice—providers need independent evidence like police reports, witness statements, or medical records documenting accident-related injuries.

The decision also counsels providers about evaluating cases before investing litigation resources. When carrier discovery produces clear “no accident” testimony from insureds, providers should carefully assess whether they possess evidence sufficient to create fact questions. Pursuing cases where the insured definitively denies any accident occurred, without strong contradictory proof, likely wastes time and money.

Related Articles

• Absence of a business record entry = no motor vehicle accident
• Understanding New York’s One Year Rule in No-Fault Insurance Claims
• Causation in Personal Injury Cases: Understanding 5102(d) Standards in New York
• New York Personal Injury Law: Proving Causation in Accident Cases
• Personal Injury

Legal Update (February 2026): Since this 2018 post, practitioners should be aware that Insurance Regulation 65-3.14 regarding contact requirements for no-fault coverage may have been subject to interpretive updates or clarifying amendments. Additionally, case law developments since 2018 may have further refined the “discernible nexus” standard for establishing causation between motor vehicle instrumentalities and injuries in no-fault claims.