Claim Denied?
100,000+ No-Fault Cases. We Know Every Trick.
Insurance carriers deny legitimate claims using verification delays, peer review opinions, and EUO traps. Jason Tenenbaum has handled over 100,000 no-fault cases and written 2,600+ articles on these exact defenses.
Serving Long Island, Nassau County, Suffolk County & All of NYC
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Every Denial Has a Weakness
Why Was Your Claim Denied?
Medical Necessity Denial
The carrier relies on a peer review or IME opinion that the treatment was not medically necessary; the denial must set out a factual basis and a medical rationale, and the provider answers it with proof of necessity.
EUO No-Show Defense
The carrier says the provider or the injured person failed to appear for an examination under oath; it must prove the scheduling letters were mailed and the examination was not attended.
Verification Defense
The carrier says verification it requested was never supplied. A claim is not overdue while a proper request is outstanding, and the request and any follow-up must be proved (11 NYCRR 65-3.5, 65-3.8).
Fee Schedule Reduction
The carrier pays less than billed under the workers' compensation fee schedule; the dispute is whether the code, the rate and the reduction were correct.
IME Cutoff
After an independent medical examination the carrier stops paying for further treatment; the examiner's report and its rationale decide whether the cutoff holds.
Late Claim Filing
The carrier says the accident notice or the bill arrived after the deadline in the policy endorsement (11 NYCRR 65-1.1); a late submission may be excused with a reasonable justification.
Policy Exhaustion
The carrier says the $50,000 in basic economic loss has been paid out; whether the claims were paid in the order the regulation requires (11 NYCRR 65-3.15) is the question.
Fraud Investigation Defense
The carrier alleges a staged accident, a fraudulently procured policy, or a provider that is not properly licensed or owned; each theory carries its own proof burden.
Proven Track Record
Denials Exposed. Claims Recovered.
No-fault cases are high volume. These results reflect the kind of recoveries we secure by dismantling carrier defenses one by one.
$450K
Medical Provider Recovery
Aggregate recovery across multiple denied claims after the carrier's pattern of untimely handling was shown
$250K
Overturned IME Cutoff
Insurer relied on a single IME to cut off all treatment; the report did not hold up at arbitration
$180K
Fee Schedule Dispute
Carrier reduced reimbursements below the workers' compensation fee schedule; the full amount was restored
$150K
EUO No-Show Defense Defeated
Carrier claimed the provider missed the EUO; the scheduling letters were never properly mailed
$125K
Verification Defense Overturned
Insurer issued boilerplate verification requests to run out the clock; the defense was untimely
$95K
Late Denial Penalty
Carrier denied the claim 47 days after receipt, past the 30-day deadline under Insurance Law § 5106
Past results do not guarantee a similar outcome. Each case is unique.
Simple Process
Getting Started Takes 5 Minutes
Call or Click
Reach us 24/7 at (516) 750-0595 or submit your denial online. We respond within minutes.
Free Claim Review
We review your denial letter, identify every procedural defect, and explain your options. No jargon, no pressure.
We Fight the Carrier
We handle arbitration, litigation, appeals — everything. We demand the full claims file and dismantle their defense.
Why Tenenbaum Law
The No-Fault Authority
No-fault insurance law is our foundation. Jason Tenenbaum has spent 24 years immersed in this practice area — representing both sides, shaping the case law, and writing the articles that other attorneys cite. No firm in New York brings this depth of no-fault experience to your denial.
100,000+ No-Fault Cases Handled
Unmatched volume experience across every denial type — medical necessity, EUO, verification, fee schedule, and more.
2,600+ Published Articles on No-Fault Law
The deepest no-fault knowledge base of any firm in New York — covering every regulation, defense, and appellate decision.
Both Sides Expertise
We defend carriers and represent providers — so we know every tactic, every loophole, and every weakness in a carrier's denial.
Appellate Authority
1,000+ appeals handled — shaping the very case law that carriers and arbitrators rely on in no-fault disputes.
"After two other firms told us nothing could be done, Jason's team got every single denied claim overturned. They knew exactly what the carrier did wrong and proved it at arbitration."
Dr. M. Patel
Medical Provider, Nassau County
The Legal Framework
NY No-Fault Denial Law
The regulations governing no-fault claims are dense and procedural. Every deadline, every notice requirement, every verification rule is a potential weakness in the carrier's denial. Here is the framework we use to dismantle them.
Insurance Law §5106 — Prompt Payment
Carriers must pay or deny within 30 days of receiving proof of claim. Failure to comply means the denial may be untimely — precluding nearly all defenses.
11 NYCRR 65-3.5 — Verification Procedures
Carriers must request verification within 15 business days of receiving a claim. Late or defective requests waive the verification defense entirely.
11 NYCRR 65-3.8 — Denial Timeframes
Strict timelines govern when a carrier must issue a denial of claim form (NF-10). Missing the window creates an untimely denial defense for the claimant.
Medical Necessity & Peer Review
Carriers rely on peer reviews and IMEs to deny treatment as not medically necessary. These opinions are rebuttable with the treating physician's clinical findings and contemporaneous records.
EUO Scheduling Requirements
Carriers must properly schedule and mail EUO notices. Failure to prove proper mailing of two notices — or unreasonable scheduling conditions — defeats the EUO no-show defense.
Fee Schedule (Workers' Comp Rates)
No-fault reimbursement is tied to the Workers' Compensation fee schedule. Carriers frequently miscalculate or improperly reduce payments below allowable rates.
Untimely Denial Defense
When a carrier fails to deny within the regulatory timeframe, it is precluded from asserting most coverage defenses — one of the most powerful tools in no-fault litigation.
Arbitration vs. Litigation
Most no-fault disputes proceed through AAA arbitration, but complex cases may warrant Civil Court litigation. We handle both and recommend the path that maximizes your recovery.
We have written extensively on every one of these topics. Browse our 2,600+ articles for deep dives into specific no-fault defenses and case law.
What this page covers, and what it does not
This page is about first-party no-fault benefits under Insurance Law Article 51 and 11 NYCRR Part 65: the claims of medical providers who treated a person injured in a motor vehicle accident, and the claims of the injured person for medical bills, lost wages and other expenses. That is the insurance work the firm does. The firm does not take homeowner, flood, life, disability, health or ERISA claim denials, and it does not bring bad-faith actions against carriers on those policies.
If your denial is on one of those policies, the New York Department of Financial Services takes consumer complaints against insurers at dfs.ny.gov/complaint, and a lawyer who handles that line of coverage should read the denial letter and the policy.
If your denial is a no-fault denial, the rest of this page and the firm's case notes are written for you.
Read the decisions on each denial type
Every defense on this page has a topic in the firm's Legal Encyclopedia: the case notes, in date order, with the rule as the courts have stated it and the decisions that changed it.
Verification
Requests, follow-ups, the 120-day rule and Chapa v MVAIC.
Examinations under oath
Scheduling, timeliness, the no-show and the proof of it.
IME no-shows
Mailing of the notices, the affidavit of non-appearance, the cutoff.
Medical necessity
Peer reviews, IME reports, the factual basis and medical rationale.
Fee schedule
Workers' compensation rates, codes, reductions and defenses.
Priority of payment and exhaustion
11 NYCRR 65-3.15, policy exhaustion, and how arbitration awards have been reviewed.
Mailing and proof of service
The presumption of mailing and what an office-practice affidavit must say.
Claim timing and late denials
The 30-day rule, tolling, preclusion and interest at two percent a month.
The whole no-fault archive
Seventeen topics, every case note since 2008, newest first.
Common Questions
No-Fault Denial FAQ
Why was my no-fault claim denied?
What is an EUO and can my claim be denied for missing it?
What is a verification defense?
How long does the insurance company have to pay a no-fault claim?
Can I fight a medical necessity denial?
What if the denial was late?
Should I arbitrate or litigate my no-fault denial?
How much does a no-fault denial lawyer cost?
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Written By
Jason Tenenbaum, Esq.
Jason Tenenbaum is a personal injury attorney serving Long Island, Nassau & Suffolk Counties, and New York City. Admitted to practice in NY, NJ, FL, TX, GA, MI, and Federal courts, Jason is one of the few attorneys who writes his own appeals and tries his own cases. Since 2008, he has authored more than 2,600 articles on no-fault insurance law, personal injury, and employment law — a resource other attorneys rely on to stay current on New York appellate decisions.
Every Denial Has a Weakness
Every Denial Has a Weakness. We've Exposed Thousands of Them.
Insurance carriers count on you accepting the denial. They do not count on facing an attorney who has handled 100,000 of these cases and knows their playbook better than they do. Review the legal encyclopedia for no-fault denial law, see our no-fault defense practice area for related claims, or visit our Long Island car accident lawyer page for the broader PI context. The consultation is free. The fight starts now.
No fee unless we win. Available 24/7. Hablamos Español.