All were trial-court rulings. Relying on the Fourth Department's Gepp, Civil Court, Kings County, held that written verification requested after an EUO that left needed information unanswered kept the claim tolled, rejecting reliance on Burke Physical Therapy. The same court held that MVAIC, though exempt from 11 NYCRR 65-3.5 (k), failed on summary judgment to establish nonreceipt of bills the provider swore it faxed with an affidavit covering only mailed bills. Another Kings County judge gave res judicata and collateral estoppel effect to a Supreme Court default order declaring no coverage for the same collision (Parisien v ZipCar), and Civil Court, Richmond County, held it cannot issue preliminary injunctions.
Our summary of the month’s decisions, not the courts’ words.
Trial court, First Department
Aug 24, 2026
2026 NY Slip Op 51435(U)
Insurer prevailed
The defendant insurer established that a separate company issued the assignor's policy and that it was not a proper party. The Civil Court, New York County, granted summary judgment under CPLR 3212 (b) and dismissed the provider's no-fault reimbursement complaint. The defendant's records search located no policy covering the assignor, while a claims representative for the separate issuing insurer identified the relevant policy and claim number. The provider's conclusory assertions concerning the issuer's identity and the companies' relationship raised no triable issue. Whether the defendant received the bills or issued a lack-of-coverage denial was immaterial to the jurisdictional issue presented.
Trial court, Second Department
Aug 20, 2026
2026 NY Slip Op 51339(U)
Insurer prevailed
Post-EUO verification requests continue tolling when the EUO fails to supply information necessary to verify the claim. The insurer submitted the EUO transcript and an SIU affidavit establishing that necessary information remained outstanding. Following Nationwide Affinity Ins. Co. of Am. v Gepp and 11 NYCRR 65-3.5 (c), the Civil Court, Kings County, rejected the provider's arguments that the completed EUO ended tolling and that the written request eight days later was untimely. The provider did not respond within 120 days; its later statement of intent to supply verification did not constitute a response. The insurer was entitled to deny the claim, and the court granted its CPLR 3212 summary judgment motion in its entirety and denied the provider's cross motion.
Trial court, First Department
Aug 19, 2026
2026 NY Slip Op 51329(U)
Provider prevailed
The insurer failed to establish timely, proper mailing of its initial verification request, defeating summary judgment for nonresponse. The Civil Court, Bronx County, denied the insurer's motion under CPLR 3212. The adjuster's affidavit described mailing procedures for the follow-up request but omitted the processing steps for the initial request; conflicting mailing dates also raised a factual issue. Although 11 NYCRR 65-3.5 (o) permits denial after 120 days without verification or reasonable justification, the insurer did not establish tolling. The court found requests for signed claim and assignment forms reasonable and rejected the provider's demand for separate copies to it and counsel under 11 NYCRR 65-3.6 (b). Timely, proper mailing remained for trial; if proven, the action was premature.
Trial court, Second Department
Aug 18, 2026
2026 NY Slip Op 51401(U)
Provider prevailed
MVAIC failed to establish nonreceipt of three bills, and the provider raised a medical-necessity issue on six others. The Civil Court, Kings County, described MVAIC's summary judgment motion as granted to an extent, but left all nine bills for trial and noted payments reducing five disputed balances. Although MVAIC was exempt from 11 NYCRR 65-3.5 (k), its mailing-only receipt affidavit omitted fax procedures or a policy rejecting fax submissions. The provider's affidavits describing transmission to MVAIC's conceded fax number defeated summary judgment, but did not establish timely submission without the bills themselves. A physician's rebuttal affidavit raised a factual issue concerning medical necessity for the other six bills.
Trial court, Second Department
Aug 7, 2026
2026 NY Slip Op 26130
Insurer prevailed
A default declaratory order expressly determining no-fault coverage can preclude a provider's claims even without entry of a final judgment. The Civil Court, Kings County, granted the defendant's directed-verdict motion under CPLR 4401 and dismissed the action. The court took judicial notice under CPLR 4511 (b) of a Supreme Court order declaring no coverage for the same collision based on EUO nonappearances. The order had not been vacated, and the provider and assignor had been served but failed to appear. The court applied res judicata and collateral estoppel, rejecting objections to the order's admissibility and finality. An earlier summary judgment ruling addressing a different declaratory order did not foreclose the defense under law of the case.
Trial court, Second Department
Aug 5, 2026
2026 NY Slip Op 51283(U)
Provider prevailed
The insurer's request to stay the provider's trial pending a declaratory judgment action failed for lack of a supported basis. The Civil Court, Richmond County, denied a stay under CPLR 2201 and a preliminary injunction under CPLR 6301. The insurer sought relief on the business day before trial, after waiting nearly 18 months following its stated investigation results to commence the declaratory judgment action. It supplied no facts supporting undue burden, identified no other pending cases and could litigate its fraud defense at trial. No dispositive motion was pending in the declaratory judgment action, leaving the delay indefinite and prejudicial to the provider. Under New York City Civil Court Act §§ 202 and 203, the court lacked authority to issue a preliminary injunction.
