CPLR 3212(g) struck
New York appeals court clarifies burden of proof standards in no-fault insurance cases, addressing when plaintiffs must prove compliance with verification requests at trial.
Read More →Prima Facie case
73 articles by Jason Tenenbaum, Esq.
Prima facie case for trial purposes
Analysis of two NY appellate cases establishing prima facie requirements for no-fault insurance trials, including burden of proof for claim submission and payment denial.
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Summary judgment not unavailable under Etienne
Court confirms summary judgment remains available under Etienne standard, requiring only timely disclaimer and legal merit for no-fault insurance defenses.
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2106 and a prima facie comment
Court ruling on CPLR 2106 affirmations and prima facie requirements for no-fault insurance claims, including chiropractor limitations and 30-day payment rules.
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Prima facie case in MVAIC matter
Court ruling clarifies MVAIC prima facie case requirements, emphasizing medical providers must prove NY residency and notice of intention filing beyond basic claim submission.
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Etienne applied differently in First Department
Second Department Appellate Term applies Viviane Etienne precedent differently than First Department, showing varying interpretations of prima facie standards in no-fault cases.
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The errant notice to admit
Court rules improper notice to admit cannot establish prima facie case for no-fault insurance EUO nonappearance, highlighting discovery limits in litigation.
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The denial is the operative document for prima facie purposes
Kings County Civil Court rules that receiving an NF-10 denial form from an insurer is sufficient to establish prima facie proof that a medical claim was properly submitted and received.
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What is a prima facie case? I still do not have an answer
Court of Appeals clarifies prima facie case requirements for no-fault insurance summary judgment, requiring proof of mailing and business records compliance.
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The prima facie case in the First Department and sinking of a disclosure based defense
First Department ruling on prima facie case requirements in no-fault insurance, waiver of assignment defenses, and discovery limitations in provider claims.
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Prima facie case not established
New York court ruling demonstrates how healthcare providers can fail to establish prima facie cases in no-fault insurance disputes by not proving timely payment or denial issues.
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Prima facie case
Court reaffirms essential elements of prima facie case in no-fault insurance claims, emphasizing medical providers must prove denial issues beyond just non-payment.
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Motion to strike “3212(g) findings” denied
Court denies motion to strike CPLR 3212(g) findings in no-fault case, but leaves open question about plaintiff's appeal rights when judges refuse to make such findings.
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A prima facie case – not too much needed
Court affirms that third-party biller testimony alone can establish prima facie case in no-fault insurance disputes, following Viviane Etienne precedent.
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Prima Facie post Etienne
Eagle Surgical Supply v Allstate case establishes methods for proving prima facie cases in NY no-fault insurance claims using NF-10 denial forms as evidence.
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Summary judgment is limited to what is pleaded upon the moving papers
Court ruling clarifies that summary judgment motions are limited to specific pleadings, requiring defendants only address claims actually raised in no-fault cases.
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Lost wage claim requires affirmative proof of disability
Lost wage claims in NY no-fault insurance require medical testimony proving disability and non-speculative income evidence. Court analysis of Gordon v Chubb case.
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Another Prima facie again
Court ruling demonstrates how insurance companies waive their right to challenge claim form deficiencies if not raised during initial claims process.
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A formulation of a prima facie case
Court ruling shows how healthcare providers can establish prima facie cases in no-fault insurance disputes by proving proper billing submission and insurer's failure to respond.
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Another prima facie case – refining Etienne
Court case refines prima facie requirements for no-fault insurance claims, clarifying medical providers don't need business records exception proof in NY.
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First Application of Etienne
Westchester Med. Ctr. v Allstate case analysis: prima facie requirements under Etienne standard vs. Mary Immaculate precedent in NY no-fault claims.
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A prima facie case involving durable medical equipment
Court ruling demonstrates how incomplete delivery documentation can derail a durable medical equipment provider's prima facie case for no-fault insurance benefits.
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Partial Summary Judgment granted on appeal
NY Appellate Term allows appeals of partial summary judgment orders on prima facie case and timely denials in no-fault insurance litigation.
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Amended motion/Admissible Reply papers/Defects in affidavits/delay letter vs. verification requests
Court ruling on amended motions, defective IME affidavits, and delay letters vs. verification requests in New York no-fault insurance litigation procedures.
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All you wanted to know about 4518(a) but were afraid to ask
Learn about CPLR 4518(a) business records foundation requirements in New York no-fault insurance cases, including hearsay exceptions and evidence admissibility rules.
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Prima facie case lost
New York court ruling shows healthcare providers face uphill battle when using third-party billing services to establish prima facie cases in no-fault insurance claims.
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Something involving collateral estoppel and prima facie happened here?
Court rules plaintiff failed to establish prima facie case for no-fault insurance recovery, lacking evidence to connect claim forms to prior judgment and proof of unpaid status.
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Assignment not necessary to make a prima facie case in an assigned first-party action; Prima Facie case
Urban Radiology v GEICO: Assignment of benefits not required for prima facie case in first-party no-fault actions. Court clarifies trial vs summary judgment standards.
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A preclusion order renders the defense deficient as a matter of law – prima facie burden established
Court awards summary judgment to no-fault provider when preclusion order renders insurance company's defense legally insufficient, establishing prima facie case.
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UB-04 + nothing else does not equal Prima Facie
Court rules UB-04 forms alone don't establish prima facie no-fault claims - NF-5 forms required to trigger 30-day payment period under New York insurance law.
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Another less than noteworthy prima facie decision
Analysis of New York Diagnostic Med. Care v GEICO decision on prima facie requirements in no-fault insurance claims and medical necessity standards.
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Watch how Plaintiff made prima facie
Compas Med case shows how plaintiff established prima facie case despite untimely EUO denials, demonstrating strategic forum shopping in NY no-fault law
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Another in the never ending line of prima facie disasters
Court ruling demonstrates the challenging burden healthcare providers face when establishing prima facie cases in no-fault insurance summary judgment motions.
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Navigating New York No-Fault Additional Verification Challenges: Long Island Healthcare Providers
Understanding New York no-fault additional verification requirements and challenges for healthcare providers. Expert legal guidance for Long Island practices. Call (516) 750-0595.
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The trouble with proving prima facie on summary judgment as a plaintiff
NY Second Department makes prima facie cases nearly impossible for medical providers. Expert analysis of no-fault litigation challenges. Call 516-750-0595.
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IME no-show defense defeated based upon affidavit issue – prima facie denied based upon a denial which Defendant did not prove was mailed
IME no-show defense defeated due to affidavit gap - court denies prima facie case where defendant failed to prove mailing of denial for one cause of action
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Again – prima facie
Court ruling demonstrates how healthcare providers must prove insurance companies failed to timely pay or properly deny no-fault claims to establish prima facie case.
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Final order of preclusion became automatic – no need to move for one
Court rules conditional preclusion order becomes automatic upon non-compliance, but plaintiff still must prove prima facie case for summary judgment
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Summary judgment granted under the new interpretation of prima facie
Court grants summary judgment under new prima facie interpretation for no-fault billing manager affidavit establishing timely claim submission within 45 days.
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Prima facie gone bad
A 2012 case shows how medical providers can lose no-fault summary judgment motions when their affidavits fail to clearly establish the insurer's denial was untimely or legally insufficient.
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Another prima facie disaster in the second department
Second Department court ruling in Flatlands Med. v Allstate shows strict prima facie requirements for no-fault insurance summary judgment motions under CPLR 3212(g).
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No Fault and Uninsured Motorist subrogation
Court ruling on no-fault and uninsured motorist subrogation requiring physical examination and prima facie proof of serious injury and medical necessity.
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A passenger may move for partial summary judgment re: liability
Passenger wins partial summary judgment on liability in NY appellate case, demonstrating effective legal strategy for innocent passengers in multi-vehicle accidents.
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Second Medical – loses at prima facie again
Second Medical loses another prima facie case in NY personal injury law. Learn what makes a strong prima facie case and avoid common litigation mistakes.
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Prima facie really does not mean prima facie
Court clarifies that prima facie showing in summary judgment only shifts burden, doesn't establish facts for trial in no-fault insurance cases.
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A universal definition of a prima facie case
Court establishes universal definition for prima facie cases in no-fault insurance disputes, showing how proper documentation and timely filing create entitlement to summary judgment.
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Judge Hirsh says there is no difference in a hopsital and a standard medical provider's prima facie case
Judge Hirsh clarifies that hospitals and standard medical providers have identical prima facie case requirements in New York no-fault insurance litigation.
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Understanding No-Fault Insurance Claims: When Basic Legal Requirements Are Overlooked
Expert analysis of Quality Health Products v Country-Wide Insurance Co. Learn how to properly establish no-fault insurance claims in Long Island and NYC. Call 516-750-0595 for consultation.
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A new twist on prima facie
New York appellate court case shows how inadequate documentation can doom a no-fault insurance claim, highlighting the evolving standards for prima facie cases.
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Account Stated Claims in New York: Why Failure to Annex Bills Requires Automatic Denial
Essential account stated claim requirements in NY after Cutler decision. Why failure to annex billing statements requires automatic denial. Expert legal analysis.
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Understanding Third-Party Billing Records in New York No-Fault Claims: Appellate Term’s First Application of Carothers
Expert analysis of Appellate Term decision on third-party billing records in NY no-fault claims. Carothers application from experienced Long Island attorney.
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The Appellate Division, Second Department has again held that a prima facie case involves a business record foundation for the entry of the bills into evidence
Appellate Division Second Department rules on prima facie case requirements for no-fault insurance claims, emphasizing business record foundations for medical bills.
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An account stated must be supported by evidence in admissible form
New York court rules that account stated claims require proper business records foundation under CPLR 4518, not just submission of credit card statements without authentication.
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Be careful what you ask for: Discovery by summary judgment motion
Learn how summary judgment motions in no-fault insurance cases can backfire on carriers when discovery rules work against them in medical necessity disputes.
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Notice to Admit is successful in District Court
District Court allows Notice to Admit to satisfy prima facie burden in no-fault case, despite Second Department precedent requiring business records foundation.
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Why don't Defendant's start to use the Notice to Admit to establish their Prima Facie? Am I missing something?
Exploring whether defendants can use Notices to Admit to establish prima facie cases in New York no-fault insurance litigation and departmental differences.
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And why would you not bring your case in Manhattan or the Bronx?
Central Nassau Diagnostic Imaging v GEICO case shows how providers can use admissions from notices to admit to establish prima facie cases for no-fault benefits.
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The denial of claim form does not need to be placed into evidence
Court ruling explains when denial of claim forms don't need business records exception - hearsay rules in no-fault insurance evidence cases on Long Island.
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Where you can go wrong on a liability case – an interesting and scary read
A cautionary tale about how failing to establish basic liability elements can lead to directed verdicts and potential malpractice claims in personal injury cases.
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What is a prima facie case in the Second Department?
Court procedural order granting extension to file reply brief in no-fault insurance case between medical provider and GEICO, showing typical appellate timeline management.
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A tongue twister from the Fourth Department
Fourth Department appellate court ruling on res judicata, law of the case doctrine, and prima facie requirements in no-fault insurance mailing disputes.
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Intervenor major medical insurance carrier tried to recoup settlement proceeds between the injured person and the tortofeasor – but to no avail
Intervenor health insurance carrier fails to recoup settlement proceeds due to inadequate proof of business records and prima facie case requirements in NY court.
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A civil court upholds Domotor, but applies it in a strange fashion
Understanding how NY courts apply the Domotor case in no-fault insurance disputes. Long Island and NYC personal injury attorney explains the legal implications.
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Prima Facie Case Requirements in NY No-Fault Insurance: Avoiding the Omni Chiropractic Mistake
Analysis of Omni Chiropractic v Travelers case on prima facie case requirements in NY no-fault insurance claims, including overdue payment proof and litigation strategy.
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A prima facie case of medical necessity?
Understanding medical necessity proof standards in NY personal injury and no-fault cases. Expert legal analysis from Long Island attorneys. Call 516-750-0595.
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Carothers v. Geico: The No-Fault Business Records Showdown
Analysis of Carothers v. Geico and its impact on no-fault insurance business records requirements in New York. Expert legal insight from Tenenbaum Law. Call 516-750-0595.
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The Fourth Department for the first time in a decade has discussed the issue of what constitues a prima facie case
Learn how the Fourth Department aligned with other NY appellate divisions on prima facie case requirements in no-fault litigation. Key legal development for providers.
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Understanding Prima Facie Cases in New York No-Fault Insurance Law
Learn about prima facie case requirements in New York no-fault insurance litigation. Expert guidance for medical providers on establishing strong claims. Call 516-750-0595.
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Pine Hollow Dead: Business Records Rule Restored in NY Personal Injury Law
Pine Hollow case overruled, restoring proper business records standards in NY personal injury law. Expert analysis from experienced Long Island attorney.
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The Court offers some guidance as to the business records exception
New York Court guidance on business records exception under CPLR 4518 for Long Island and NYC practitioners handling personal injury and litigation cases.
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And then the Appellate Division, Second Department spoke
Appellate Division Second Department's Art of Healing ruling reshapes no-fault insurance prima facie case requirements, rejecting literal Mary Immaculate interpretation for NY providers.
Read More → Prima facie: schizophrenia from the Appellate Term
Analysis of prima facie evidence requirements in New York no-fault insurance litigation, examining appellate court inconsistencies in the Mary Immaculate Hospital case.
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Understanding No-Fault Insurance Claims: The Dan Medical Case and Its Impact on Long Island Residents
Understand NY no-fault insurance law & the Bajaj case impact on Long Island residents. Expert legal analysis. Call 516-750-0595 for free consultation.
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