Against MVAIC, was the claimant shown to be a qualified, covered person meeting article 52’s conditions?

Deciding this question means ruling on whether the injured person (and so the assignee provider) is eligible for benefits from MVAIC under Insurance Law article 52: a 'qualified person' under § 5202 (b) (New York resident, not an insured, not the owner of the uninsured vehicle), injured by an uninsured or unidentified vehicle after other available coverage was exhausted (Hauswirth), who complied with the article 52 conditions (timely notice of intention / affidavit to MVAIC under § 5208, 24-hour accident report for hit-and-run, reasonable efforts to identify the vehicle under § 5218) and is therefore a 'covered person' under § 5221 (b) (2). It also covers rulings on who must prove these facts and on whether MVAIC's untimely denial or verification precludes or waives the eligibility defense. Categories record what the court held on eligibility in this case, and the split between the two 'not established' categories shows which side the court put the burden on.

The departments are split. The elements are settled: qualified person under § 5202 (b), covered person only after compliance with article 52 (§ 5221 [b] [2]), timely § 5208 notice as a condition precedent, exhaustion against a known owner/driver before MVAIC (Hauswirth, 2d Dept 1997), and an eligibility defense is a lack-of-coverage defense not subject to 30-day preclusion (AD1 Interboro 2010; App Term 2d RAZ 2009, Ocean Diagnostic 2005, Apollo 2016), even though MVAIC is otherwise bound by the 30-day rule (AD2 New York Hosp. 2004). What divides the courts is WHO must prove eligibility: the First Department (Interboro; App Term 1st since 2010) puts the burden on MVAIC as a lack-of-coverage defense, while the Appellate Term, Second Department treats qualified/covered status, exhaustion, residency and the § 5208 affidavit as conditions precedent that the claimant must prove, including at trial as part of its prima facie case (Modern Art 2008 through Masigla 2025). The Appellate Division, Second Department (Englington 2011) held that MVAIC as summary-judgment movant must make the prima facie showing and the claimant need not prove qualified status 'in the first instance' on that motion, which sits uneasily with App Term 2d decisions that grant MVAIC summary judgment because the plaintiff did not demonstrate exhaustion. A precludability outlier exists at trial level (Sama Physical Therapy v MVAIC, Civ Ct Queens 2019: qualified-person defense subject to preclusion).

Leading authorities · Authority map · Decisions by court · Plain-text version (Markdown)

Leading authorities

Englington Med., P.C. v Motor Veh. Acc. Indem. Corp. (2011 NY Slip Op 00176) Appellate Division, Second Department, 2011MVAIC as movant must prove claimant not a qualified personOn MVAIC's summary judgment motion, MVAIC had to establish prima facie that the hit-and-run victim was not a qualified person (owner of an uninsured vehicle required to be insured, or a motorcycle rider); a claim form saying 'Mini-Bike' and VTL summonses did not suffice, and the provider did not have to prove qualified status in the first instance.
Moreover, Englington, as the opponent of MVAIC’s motion for summary judgment, did not have a burden, in the first instance, of establishing that Cruz was a “qualified person” or that it was entitled to no-fault benefits as Cruz’s assignee.
Later history: Affirms the App Term order in Englington Med., P.C. v MVAIC (2008 NY Slip Op 52179(U)); companion Greater Health Through Chiropractic v MVAIC (16536) affirms App Term 16334
Matter of MVAIC v Interboro Med. Care & Diagnostic PC (2010 NY Slip Op 04522) Appellate Division, First Department, 2010First Department: coverage defense not precluded; burden on MVAICAn arbitrator could not refuse to hear MVAIC's defense that the offending vehicle was insured because MVAIC denied late: lack of coverage is an exception to the 30-day rule, NY Hosp did not involve coverage, and MVAIC bears the burden of proving the defense.
We would add that the burden is on MVAIC to prove its lack-of-coverage defense.
New York Hosp. Med. Ctr. of Queens v Motor Veh. Acc. Indem. Corp. (2004 NY Slip Op 08087) Appellate Division, Second Department, 200430-day rule binds MVAIC before it qualifies the claimantMVAIC has the rights and obligations of an article 51 insurer, so the 30-day pay-or-deny period runs without waiting for MVAIC to 'qualify' the injured person; having neither denied nor sought verification in time, and not objecting to the claim form within 10 days, MVAIC could not defeat the hospital's summary judgment.
the defendant’s contention that the 30-day time requirement contained in 11 NYCRR 65.15 (g) (3) does not apply to it until after it has “qualified” an injured party.
Later history: lv denied 4 NY3d 705 (2005) (as cited in 16230, 16438, 16504); distinguished as not involving lack of coverage in Matter of MVAIC v Interboro (16438) and RAZ Acupuncture v MVAIC (16424)
Modern Art Med., P.C. v MVAIC (2008 NY Slip Op 52586(U)) Appellate Term, Second Department, 2008Second Department App Term: claimant must exhaust remedies against known ownerBecause the provider and its assignor knew who owned the vehicle the assignor was driving, the provider had to exhaust its remedies against the owner before seeking benefits from MVAIC; having not shown exhaustion, it was not entitled to summary judgment.
Since plaintiff and its assignor were aware of the identity of the owner of the vehicle which plaintiff’s assignor was driving at the time of the accident, plaintiff, as assignee, was required to exhaust its remedies against the vehicle’s owner before seeking relief from MVAIC
Avicenna Med. Arts, P.L.L.C. v MVAIC (2016 NY Slip Op 51535(U)) Appellate Term, Second Department, 2016Timely § 5208 affidavit is part of claimant's prima facie caseA timely affidavit giving MVAIC notice of intention to make a claim is a condition precedent to covered-person status; because the provider did not establish at trial that one was submitted, it failed to make out its prima facie case and the complaint was dismissed.
As plaintiff did not establish that such an affidavit had been submitted to MVAIC, plaintiff failed to establish its prima facie case (see Insurance Law §§ 5202 [b]; 5208, 5221 [b] [2]).
Ocean Diagnostic Imaging v Motor Veh. Acc. Indem. Corp. (2005 NY Slip Op 51271(U)) Appellate Term, Second Department, 2005No timely notice of claim: not a covered person; late denial irrelevantMVAIC's untimely denial did not matter because it rested on lack of coverage; since the assignor neither filed a timely notice of claim nor sought leave to file late, the assignor was not a covered person and MVAIC was entitled to dismissal.
Inasmuch as the record establishes that plaintiff’s assignor failed to file a timely notice of claim or seek leave to file a late notice of claim (see Insurance Law § 5208 [a], [c]), plaintiff’s assignor was not a “covered person” (see Insurance Law § 5221 [b] [2])
Hauswirth v American Home Assur. Co. 244 AD2d 528Source of the exhaustion-of-remedies rule: a claimant who knows the owner/driver must exhaust remedies against them (and their carriers) before MVAIC; claim premature until then. Cited by 87 candidates.Not in our database.
Matter of Motor Veh. Acc. Indem. Corp. v Aetna Cas. & Sur. Co. 89 NY2d 214Only 'qualified persons' are entitled to MVAIC no-fault coverage (cited in Englington and ~17 candidates).Not in our database.
Canty v Motor Veh. Acc. Indem. Corp. 95 AD2d 50924-hour accident-report requirement of § 5208 (a) (2) and its excuse; cited for hit-and-run claimants (10 candidates).Not in our database.
Matter of Acosta-Collado v Motor Veh. Acc. Indem. Corp. 103 AD3d 714Exhaustion before MVAIC; cited by App Term 2d from 2017 for prematurity (e.g. Continental Med. 17511).Not in our database.
Central Gen. Hosp. v Chubb Group of Ins. Cos. 90 NY2d 195Lack-of-coverage defenses are not subject to 30-day preclusion; relied on to hold MVAIC's eligibility defense non-precludable.Not in our database.
Knight v Motor Veh. Acc. Indem. Corp. 62 AD3d 665Plaintiff (personal-injury action) failed to establish qualified-person status; distinguished in Englington.Not in our database.

Authority map

Each circle is a decision on this question, placed by court and date; its colour is the position it took. Lines are citations between them. Select a circle (or find a decision by name) to see its links and summary. The same decisions are listed by court below the map.

Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundEligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureMVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointCourt finds the claimant qualified/covered, or the condition met or excused, on the claimant's own proofEligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedMVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverRing: rules on the question, but another ground decided the caseContrasted, distinguished or limitedDeclined to follow, questioned, overruled or reversedCited Show ordinary citations

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How the rule was applied, by court

Court	Found not eligible	Claimant's proof lacking	MVAIC failed to prove	Found eligible	Unresolved / for trial	Defense precluded/waived	Total
Appellate Division, First Department	0	0	1	0	1	0	2
Appellate Division, Second Department	0	0	2	0	0	1	3
Appellate Division, Fourth Department	0	0	0	0	1	0	1
Appellate Term, First Department	8	0	19	0	7	2	36
Appellate Term, Second Department	57	95	17	3	9	11	192
Trial courts in the First Department	3	2	0	0	0	0	5
Trial courts in the Second Department	10	4	4	2	4	4	28

Decisions (267)

Every decision in our database that rules on this question: highest court first, then by department, newest first. 251 turn on it; the others rule on it alongside a different main ground (marked "also decides"). The one-sentence summaries describe what each court said on this question.

Appellate Division, First Department (2 decisions)

Motor Veh. Acc. Indem. Corp. v NYC E.-W. Acupuncture, P.C. (2010 NY Slip Op 07111) Appellate Division, First Department, October 7, 2010MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this point (also decides)Held that MVAIC's late lack-of-coverage defense was not precluded, but the arbitrator's refusal to adjourn so MVAIC could investigate other coverage was not misconduct, since MVAIC had notice for three years and showed insufficient cause.
Matter of MVAIC v Interboro Med. Care & Diagnostic PC (2010 NY Slip Op 04522) Leading case Appellate Division, First Department, May 27, 2010Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld the arbitrator erred in refusing to hear MVAIC's defense that the offending vehicle was insured because lack of coverage is excepted from the 30-day rule, and remanded for a merits determination with the burden on MVAIC.

Appellate Division, Second Department (3 decisions)

Englington Med., P.C. v Motor Veh. Acc. Indem. Corp. (2011 NY Slip Op 00176) Leading case Appellate Division, Second Department, January 11, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld that MVAIC, as summary judgment movant, had to show prima facie that the hit-and-run victim was not a qualified person, and a claim form saying 'Mini-Bike' and uninsured-driving summonses did not show her vehicle required insurance.
Greater Health Through Chiropractic, P.C. v Motor Veh. Acc. Indem. Corp. (2011 NY Slip Op 00183) Appellate Division, Second Department, January 11, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this point (also decides)Held MVAIC's summary judgment motion was properly denied for the reasons stated in the companion appeal decided the same day.
New York Hosp. Med. Ctr. of Queens v Motor Veh. Acc. Indem. Corp. (2004 NY Slip Op 08087) Leading case Appellate Division, Second Department, November 8, 2004MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverHeld the 30-day pay-or-deny requirement binds MVAIC before it qualifies the injured person, so having neither denied nor sought verification in time, and not objecting to the claim form within 10 days, it could not defeat the claim.

Appellate Division, Fourth Department (1 decision)

Harris v Direct Gen. Ins. Co. (2017 NY Slip Op 08961) Appellate Division, Fourth Department, December 22, 2017Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld that whether the claimant owned the uninsured vehicle was a question for trial: his testimony that he co-owned and paid for it conflicted with registration, title and insurance documents naming his father as owner.

Appellate Term, First Department (36 decisions)

Performance Life Chiropractic PC v MVAIC (2023 NY Slip Op 50105(U)) Appellate Term, First Department, February 16, 2023Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because a certified DMV record showed the assignor was an insured under her own GEICO policy, so she was not a qualified person; opposition raised no triable issue.
Central Park Physical Medicine PC v MVAIC (2022 NY Slip Op 51127(U)) Appellate Term, First Department, November 17, 2022Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a qualified person because a certified DMV record showed she was insured under her own automobile policy on the accident date, and unproved timely verification did not preclude this threshold coverage defense.
Equilibrium of Life Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50113(U)) Appellate Term, First Department, February 22, 2022Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it showed no timely notice of intention to make claim was filed under § 5208, and its earlier denial on other grounds did not preclude the lack-of-coverage defense.
Community Radiology Servs., PC v MVAIC (2021 NY Slip Op 51054(U)) Appellate Term, First Department, November 10, 2021Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC, bearing the burden on lack of coverage, failed to eliminate triable issues whether the assignor was the de facto owner, since the record showed another person bought, registered and insured the vehicle.
Brookside Physical Therapy v MVAIC (2021 NY Slip Op 50998(U)) Appellate Term, First Department, October 26, 2021Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it showed no timely notice of intention was filed and the accident was not reported to police within 24 hours; its untimely denial did not preclude the lack-of-coverage defense.
Gagliardi v MVAIC (2019 NY Slip Op 52083(U)) Appellate Term, First Department, December 20, 2019Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC, bearing the burden on its lack-of-coverage defense, failed to eliminate triable issues because its own proof conflicted on whether the assignor owned the uninsured vehicle, which was registered to another person.
JJ & R Chiropractic PC v MVAIC (2019 NY Slip Op 51559(U)) Appellate Term, First Department, October 4, 2019MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointAffirmed denial of MVAIC's summary judgment motion because MVAIC failed to establish prima facie that the assignor was not a qualified person or that the provider had to exhaust remedies against the vehicle's owner.
Omega Diagnostic Imaging, PC v MVAIC (2017 NY Slip Op 50568(U)) Appellate Term, First Department, April 26, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld after trial that the bicyclist was not a covered person because he did not report the hit-and-run to police within 24 hours, having stated no police were called, and offered no excuse.

Show all 36 decisions

Karina K. Acupuncture, P.C. v MVAIC (2017 NY Slip Op 50546(U)) Appellate Term, First Department, April 24, 2017Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC's contradictory submissions, describing the assignor variously as passenger, pedestrian and operator of an unknown, uninsured or husband-owned vehicle, created triable issues of fact on eligibility, so its summary judgment motion was denied.
Karina K. Acupuncture PC v MVAIC (2017 NY Slip Op 50537(U)) Appellate Term, First Department, April 21, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor failed to report the accident to police within 24 hours, as the notice of intention showed no report and repeated requests for proof went unanswered, and plaintiff offered no dispute or excuse.
SML Acupuncture P.C. v MVAIC (2017 NY Slip Op 50539(U)) Appellate Term, First Department, April 21, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld no timely notice of claim was filed and no leave to file late was sought, so a condition precedent was unmet; MVAIC's untimely denial did not preclude this lack-of-coverage defense.
VS Care Acupuncture, PC v MVAIC (2016 NY Slip Op 50764(U)) Appellate Term, First Department, May 13, 2016Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC failed to eliminate triable issues on whether the assignor filed a notice of intention, because its own letter acknowledged receiving the notice, so its summary judgment motion was denied.
Superior Med. Rehab, PC v MVAIC (2015 NY Slip Op 51003(U)) Appellate Term, First Department, July 7, 2015MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC's limited proof, including the assignor's terse affidavit and an illegible ambulance report, did not establish as a matter of law that the assignor failed to make reasonable efforts to identify the taxi's driver or owner.
W.W. Med., P.C. v MVAIC (2014 NY Slip Op 50093(U)) Appellate Term, First Department, January 31, 2014MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverHeld MVAIC failed to show the assignor was not a qualified person because it waived objections to omissions in the notice of intention by not timely objecting or seeking verification and abandoned its 24-hour-report argument.
Hilda-Bloor Med., P.C. v MVAIC (2013 NY Slip Op 50382(U)) Appellate Term, First Department, March 20, 2013MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC submitted no competent proof that the assignor was not qualified for benefits and did not show the provider had to exhaust remedies before suing, so the provider's judgment stood apart from an interest recalculation.
Excellent Care Physical Therapy, P.C. v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 52210(U)) Appellate Term, First Department, December 6, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to meet its burden that the assignor was not a qualified person, as its own proof showed the vehicle uninsured, and the missing household affidavit was not fatal absent timely objection.
Statewide Med. Servs., P.C. v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 52119(U)) Appellate Term, First Department, November 15, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC, bearing the burden on its lack-of-coverage defense, submitted no competent proof the assignor was not qualified, and qualified status did not depend on its receipt of a household affidavit absent timely objection or verification.
Pomona Med. Diagnostics, P.C. v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 51684(U)) Appellate Term, First Department, August 30, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed its threshold burden to show the assignor was not a qualified person, because conflicting statements about possible insurance in the notice of intention did not establish a policy in effect.
Bronx Expert Radiology, P.C. v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 51617(U)) Appellate Term, First Department, August 29, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC bore the burden on its lack-of-coverage defense and, given the putative insurer's letter that the vehicle was uninsured, failed to raise a triable issue that a policy was in effect.
Dover Acupuncture, P.C. v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 51619(U)) Appellate Term, First Department, August 29, 2012Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC failed to eliminate triable issues on whether the notice of intention was timely, given conflicting receipt dates, and failed to show the vehicle was insured, so its motion was denied.
Li-Elle Servs., Inc. v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 51588(U)) Appellate Term, First Department, August 24, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to establish prima facie that the assignor was not a qualified person, so its summary judgment motion was properly denied regardless of the provider's opposition.
Premium Acupuncture, P.C. v MVAIC (2012 NY Slip Op 51534(U)) Appellate Term, First Department, August 14, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld the provider need not prove its assignors were qualified persons; MVAIC bore that burden and submitted no evidence, such as the notice of intention forms, that the assignors were not New York residents.
Canarsie Med. Health, P.C. v MVAIC (2012 NY Slip Op 51305(U)) Appellate Term, First Department, July 16, 2012Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC raised a triable issue as to whether the injuries arose from a hit-and-run accident triggering the 24-hour reporting requirement, so the providers' summary judgment was denied.
Pomona Med. Diagnostics, P.C. v MVAIC (2011 NY Slip Op 52347(U)) Appellate Term, First Department, December 29, 2011Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established the hit-and-run assignor failed to report the accident to police within 24 hours, and the provider neither disputed this nor offered an excuse, so the complaint was dismissed.
Socrates Med. Health, P.C. v MVAIC (2011 NY Slip Op 51961(U)) Appellate Term, First Department, November 2, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to raise a triable issue on its lack-of-coverage defense because it offered no competent proof the assignor was not qualified and did not show the provider had to exhaust remedies.
Pomona Med. Diagnostic, P.C. v MVAIC (2011 NY Slip Op 51891(U)) Appellate Term, First Department, October 18, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed its prima facie burden to show the assignor was not a qualified person and did not show the provider was required to exhaust remedies first, so its dismissal motion was denied.
Pomona Med. Diagnostic, P.C. v MVAIC (2011 NY Slip Op 51573(U)) Appellate Term, First Department, August 18, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC bore the burden of proving its lack-of-coverage defense and its submissions failed to establish prima facie that the assignor was not a qualified person or lacked MVAIC coverage.
Omega Diagnostic Imaging, P.C. v MVAIC (2011 NY Slip Op 50432(U)) Appellate Term, First Department, March 24, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC's motion based on the provider's failure to establish the assignor's qualification was properly denied, and MVAIC did not establish that the provider had to exhaust remedies before suing.
Omega Med. Diagnostic v MVAIC (2011 NY Slip Op 50275(U)) Appellate Term, First Department, February 25, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC, opposing the provider's prima facie showing, failed to raise a triable issue as to whether the assignor was qualified to receive benefits or failed to comply with the notice-of-claim requirement.
Pomona Med. Diagnostic v MVAIC (2011 NY Slip Op 50042(U)) Appellate Term, First Department, January 14, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to show the assignor was not a qualified person because its uncertified insurance printout was inadmissible hearsay that did not show a policy in effect, and its papers did not prove noncompliance with notice requirements.
Odessa Med. Supply, Inc. v MVAIC (2010 NY Slip Op 51930(U)) Appellate Term, First Department, November 12, 2010Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld the provider not entitled to summary judgment because MVAIC raised a triable issue on its lack-of-coverage defense by submitting competent evidence identifying a potential source of insurance for the loss.
S & L Med. P.C. v MVAIC (2010 NY Slip Op 51885(U)) Appellate Term, First Department, November 5, 2010MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld that the conceded untimely denial did not preclude MVAIC's defense that the assignor was not qualified, but MVAIC failed to establish that defense at trial, so the provider's judgment stood.
Omega Diagnostic Imaging, P.C. v MVAIC (2010 NY Slip Op 51779(U)) Appellate Term, First Department, October 15, 2010MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's arguments that the action was premature for lack of proof of qualification and failure to exhaust remedies, holding MVAIC failed to establish that an exhaustion requirement applied.
Socrates Med. Health, P.C. v MVAIC (2010 NY Slip Op 51780(U)) Appellate Term, First Department, October 15, 2010MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this point (also decides)Rejected MVAIC's argument that the provider had to establish its assignor was a qualified person, holding that the burden on that issue rests on MVAIC.
Socrates Med. Health, P.C. v Motor Veh. Acc. Indem. Corp. (2010 NY Slip Op 51606(U)) Appellate Term, First Department, September 17, 2010MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC bore the burden of proving its lack-of-coverage defense and failed to raise a triable issue because it offered no competent evidence that the loss arose from use of an uninsured vehicle.
Aronoff v Motor Veh. Acc. Indem. Corp. (2007 NY Slip Op 50958(U)) Appellate Term, First Department, May 8, 2007MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverHeld the 30-day pay-or-deny rule bound MVAIC regardless of whether it had deemed the injured person a qualified person, so its undisputed failure to pay or deny in time left no triable issue.

Appellate Term, Second Department (192 decisions)

Big Apple Med. Group Corp. v MVAIC (2026 NY Slip Op 51298(U)) Appellate Term, Second Department, June 12, 2026MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to show prima facie that the vehicle was insured on the accident date, since the out-of-state DMV abstract showed coverage only at registration two months earlier and the police report indicated no insurance.
Royal Rehab, Inc. v MVAIC (2026 NY Slip Op 50672(U)) Appellate Term, Second Department, February 20, 2026Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established it never received a timely notice-of-intention affidavit and plaintiff failed to show one was submitted, so the complaint was dismissed.
Harmonized Acupuncture v MVAIC (2026 NY Slip Op 50215(U)) Appellate Term, Second Department, February 13, 2026Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that ground (also decides)Granted MVAIC summary judgment dismissing the complaint for the reasons stated in the companion decision decided herewith, which held MVAIC proved it never received a timely notice-of-intention affidavit, so the assignor was not a covered person.
Harmonized Acupuncture v MVAIC (2026 NY Slip Op 50211(U)) Appellate Term, Second Department, February 13, 2026Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established it never received a notice-of-intention affidavit and plaintiff failed to show one was submitted, so the complaint was dismissed.
New Millennium Med. Imaging, P.C. v MVAIC (2026 NY Slip Op 50202(U)) Appellate Term, Second Department, January 23, 2026MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to show prima facie that the assignor was a VTL 128 owner of the vehicle, lacking proof of exclusive use for over 30 days or a security-interest arrangement, so it did not establish he was not a qualified person.
Harvey Family Chiropractic, Physical Therapy & Acupuncture, PLLC v MVAIC (2025 NY Slip Op 51971(U)) Appellate Term, Second Department, December 5, 2025MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to make a prima facie showing that the claimant did not satisfy the timely notice-of-intention condition precedent because it did not establish that it never received the affidavit.
Masigla v MVAIC (2025 NY Slip Op 51515(U)) Appellate Term, Second Department, August 8, 2025Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld after trial that the assignor, having had exclusive possession of the uninsured vehicle for over 30 days per the parties' stipulation, was its owner under VTL 128 and so not a qualified person.
GAO Acupuncture, P.C. v MVAIC (2025 NY Slip Op 51173(U)) Appellate Term, Second Department, July 18, 2025Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the assignor knew the identity of the owner of the vehicle she rode in, plaintiff had to exhaust remedies against the owner first and, having not shown exhaustion, its claim failed.

Show all 192 decisions

NY Wellness Med., P.C. v MVAIC (2025 NY Slip Op 51165(U)) Appellate Term, Second Department, July 11, 2025MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to show prima facie that the assignor or a household member was insured, since its ISO search showed the policies canceled before the accident, so the exhaustion-of-remedies argument failed.
Medical Supply Depot Group Corp. v MVAIC (2025 NY Slip Op 50844(U)) Appellate Term, Second Department, May 14, 2025Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a qualified person because she swore in her no-fault application that she owned the vehicle she was riding in, and granted MVAIC summary judgment absent a triable issue.
Longevity Med. Supply, Inc. v MVAIC (2024 NY Slip Op 51164(U)) Appellate Term, Second Department, July 26, 2024Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a qualified person because he owned the vehicle he was operating, so he could not be a covered person, and granted MVAIC summary judgment when plaintiff raised no triable issue.
Bronx Chiropractic Rehabilitation, P.C. v MVAIC (2024 NY Slip Op 50799(U)) Appellate Term, Second Department, June 7, 2024MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's residency objection because the assignor's notarized notice of intention giving a Brooklyn address, plus MVAIC's own household affidavit, showed New York residency and MVAIC failed to demonstrate as a matter of law that he was not a covered person.
Heal Rite, P.T., P.C. v MVAIC (2023 NY Slip Op 50287(U)) Appellate Term, Second Department, March 3, 2023Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedDenied the provider summary judgment on the remaining assignor's claim because an issue of fact existed as to whether he was a qualified, and therefore covered, person under article 52.
Bell Air Med. Supply, LLC v MVAIC (2022 NY Slip Op 51233(U)) Appellate Term, Second Department, November 18, 2022Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureAffirmed dismissal after trial because the assignee had to exhaust remedies against all potential insurance carriers before seeking relief from MVAIC and did not demonstrate that it had done so.
Lantsman Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50568(U)) Appellate Term, Second Department, June 10, 2022Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because MVAIC established it never received a timely § 5208 notice-of-intention affidavit, a condition precedent to covered-person status, and plaintiff did not show one was submitted.
Jamaica Wellness Med., P.C. v MVAIC (2022 NY Slip Op 50574(U)) Appellate Term, Second Department, June 10, 2022MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held MVAIC's 30-day period to deny or request verification ran from receipt of the claim regardless of whether it had determined the assignor was a covered person, so it failed to show it was not precluded from its lack-of-medical-necessity defense.
Metro Health Prods., Inc. v MVAIC (2022 NY Slip Op 50588(U)) Appellate Term, Second Department, June 10, 2022Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that the provider, calling no witnesses, failed to show a reasonable justification for not timely filing the notice of claim or leave of court to file late, so it did not establish covered-person status.
ZZ Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50589(U)) Appellate Term, Second Department, June 10, 2022Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it established it never received a timely affidavit giving notice of intention to claim, a condition precedent to covered-person status.
Oleg's Acupuncture, P.C. v MVAIC (2022 NY Slip Op 50593(U)) Appellate Term, Second Department, June 10, 2022Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it established it never received a timely affidavit giving notice of intention to claim, a condition precedent to covered-person status.
BNE Clinton Med., P.C. v MVAIC (2022 NY Slip Op 50058(U)) Appellate Term, Second Department, January 28, 2022Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a qualified person because he lived with his stepfather, whose auto policy covered resident relatives, and the policy did not exclude relatives over 18.
Armengol v MVAIC (2021 NY Slip Op 51207(U)) Appellate Term, Second Department, December 10, 2021Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld one assignor's claims barred because MVAIC established it never received a timely notice affidavit and another's because exhaustion against the known owner was not shown, but rejected MVAIC's argument that its 30 days awaited a covered-person determination, precluding precludable defenses for the third.
Spine Care of N.J., P.C. v MVAIC (2021 NY Slip Op 51172(U)) Appellate Term, Second Department, December 3, 2021MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held MVAIC's 30-day period to deny or seek verification ran from receipt of the claim regardless of whether it had determined the assignor to be a covered person, so it failed to show its verification requests were timely.
First Am. Alliance, Inc. v MVAIC (2021 NY Slip Op 50447(U)) Appellate Term, Second Department, May 14, 2021MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held MVAIC's 30-day period to deny ran from receipt of the claim regardless of whether it had determined the assignor was a covered person, so MVAIC failed to show it was not precluded from its medical-necessity defense.
Maiga Prods. Corp. v MVAIC (2020 NY Slip Op 50993(U)) Appellate Term, Second Department, August 28, 2020Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that proof the claimant is not the owner of the uninsured vehicle is a condition of qualified-person status, and the provider failed to establish its assignor was not the owner, so the complaint was dismissed.
Active Care Med. Supply Corp. v MVAIC (2019 NY Slip Op 52045(U)) Appellate Term, Second Department, December 13, 2019MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held that MVAIC's 30-day period ran without awaiting its determination that the claimant was a qualified and covered person, so its untimely IME no-show and verification defenses were precluded.
Tadros v MVAIC (2019 NY Slip Op 52066(U)) Appellate Term, Second Department, December 13, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the assignor knew the owner of the vehicle he rode in, so the assignee had to exhaust remedies against that owner and did not demonstrate it had done so.
Lida's Med. Supply, Inc. v MVAIC (2019 NY Slip Op 52071(U)) Appellate Term, Second Department, December 13, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the assignor knew the owner of the vehicle he was driving, requiring exhaustion of remedies against the owner, which the provider did not demonstrate.
Bronx Acupuncture Therapy, P.C. v MVAIC (2019 NY Slip Op 51694(U)) Appellate Term, Second Department, October 18, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that the provider, having not shown that a timely affidavit of intention to claim was submitted to MVAIC, did not establish covered-person status or its prima facie case, so the complaint was dismissed.
A.C. Med., P.C. v MVAIC (2019 NY Slip Op 51698(U)) Appellate Term, Second Department, October 18, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureAffirmed summary judgment for MVAIC because the provider did not demonstrate that it had exhausted its remedies against all potential insurance carriers, so its claim was premature.
Yellow Riv. Acupuncture, P.C. v MVAIC (2019 NY Slip Op 51699(U)) Appellate Term, Second Department, October 18, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundAffirmed summary judgment for MVAIC because it established that no timely notice of intention to make a claim was filed and the provider showed no leave to file late, so the assignor was not a covered person.
Lida's Med. Supply, Inc. v MVAIC (2019 NY Slip Op 51618(U)) Appellate Term, Second Department, October 11, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it established that no timely sworn notice of intention to make a claim was filed and the provider showed no leave to file late, so the assignor was not a covered person.
Starlite Acupuncture, P.C. v MVAIC (2019 NY Slip Op 51243(U)) Appellate Term, Second Department, August 2, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it established that no timely notice of intention to make a claim was filed and the provider showed no leave to file late, so the assignor was not a covered person.
Moon Rehab, P.T., P.C. v MVAIC (2019 NY Slip Op 51252(U)) Appellate Term, Second Department, August 2, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it established that no timely notice of intention to make a claim was filed and the provider showed no leave to file late, so the assignor was not a covered person.
Bronx Acupuncture Therapy, P.C. v MVAIC (2019 NY Slip Op 51253(U)) Appellate Term, Second Department, August 2, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that the provider, having not shown that a timely affidavit of intention to claim was submitted to MVAIC, did not establish covered-person status or its prima facie case, so the complaint was dismissed.
Longevity Med. Supply, Inc. v MVAIC (2019 NY Slip Op 51276(U)) Appellate Term, Second Department, August 2, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundAffirmed summary judgment for MVAIC because the record showed the assignor was a named insured and thus not a qualified person, and MVAIC established no timely notice of intention to make a claim was filed.
Promed Durable Equip., Inc. v MVAIC (2019 NY Slip Op 51152(U)) Appellate Term, Second Department, July 12, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureReversed the trial judgment for the provider because the trial evidence did not establish exhaustion of remedies against the vehicle's owner, making the claim against MVAIC premature.
Arguelles, M.D., P.C. v Motor Veh. Acc. Indem. Corp. (2019 NY Slip Op 51156(U)) Appellate Term, Second Department, July 12, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureAffirmed dismissal after trial because the provider did not demonstrate exhaustion of remedies against the owner of the vehicle in which the assignor rode, having failed to establish that vehicle's lack of coverage.
Lida's Med. Supply, Inc. v MVAIC (2019 NY Slip Op 51167(U)) Appellate Term, Second Department, July 12, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureAffirmed summary judgment for MVAIC because the hit-and-run bicyclist never provided proof of a 24-hour accident report despite requests, and the provider showed neither compliance nor that reporting was not reasonably possible.
Atlantic Chiropractic, P.C. v MVAIC (2019 NY Slip Op 51374(U)) Appellate Term, Second Department, July 12, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureReversed the trial judgment for the provider because the assignor knew the identity of the striking vehicle's owner and the provider did not demonstrate exhaustion of remedies against that owner before seeking MVAIC benefits.
T & S Med. Supply Corp. v MVAIC (2019 NY Slip Op 50737(U)) Appellate Term, Second Department, May 10, 2019MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held that the 30-day period to deny or request verification ran from receipt of the claim regardless of whether the claimant had been determined a qualified person, so the verification requests were untimely.
JCC Med., P.C. v MVAIC (2019 NY Slip Op 50676(U)) Appellate Term, Second Department, May 3, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundAffirmed summary judgment for MVAIC because it established no timely notice of intention to make a claim was filed and the provider showed no leave to file late, so the assignor was not a covered person.
Healthway Med. Care, P.C. v MVAIC (2019 NY Slip Op 50692(U)) Appellate Term, Second Department, May 3, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureReversed the trial judgment for the provider because it did not demonstrate that it had exhausted its remedies against all potential insurance carriers, so its claim against MVAIC was premature.
Veraso Med. Supply Corp. v MVAIC (2019 NY Slip Op 50274(U)) Appellate Term, Second Department, March 8, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment and denied the provider's cross motion because MVAIC established no timely notice of intention to make a claim was filed and no leave to file late was shown, so the assignor was not a covered person.
AR Med. Rehabilitation, P.C. v MVAIC (2019 NY Slip Op 51057(U)) Appellate Term, Second Department, March 1, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureReversed the trial judgment because the assignor knew the identity of the striking vehicle's owner and the provider did not demonstrate that it had exhausted its remedies against that owner before seeking benefits from MVAIC.
Starlite Acupuncture, P.C. v MVAIC (2019 NY Slip Op 50225(U)) Appellate Term, Second Department, February 22, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because it established that no timely notice of intention to make a claim was filed and the provider showed no leave to file late, so the assignor was not a covered person.
Island Life Chiropractic Pain Care, PLLC v MVAIC (2019 NY Slip Op 50226(U)) Appellate Term, Second Department, February 22, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because the record showed the assignor had bought the car he was driving a week before the accident, so as its owner he was not a qualified person.
A & S Med. Supply, Inc. v MVAIC Ins. Co. (2019 NY Slip Op 29019) Appellate Term, Second Department, January 11, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld that the liquidated carrier's admissible records proved, as the parties' stipulation required, potential coverage under a policy apparently issued to a household member, so the provider had to exhaust its remedies against that carrier and had not.
Acupuncture Approach, P.C. v MVAIC (2018 NY Slip Op 51776(U)) Appellate Term, Second Department, November 30, 2018Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that a timely affidavit of intention to claim is a condition precedent to covered-person status and that the provider, having not shown one was submitted, failed its prima facie case, so the complaint was dismissed.
New Millennium Med. Imaging, P.C. v MVAIC (2018 NY Slip Op 51684(U)) Appellate Term, Second Department, November 23, 2018Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider failed to show its motorcycle-operator assignor was eligible for MVAIC benefits because it did not prove the motorcycle was a class C vehicle exempt from the insurance requirement.
Continental Med., P.C. v MVAIC (2018 NY Slip Op 51549(U)) Appellate Term, Second Department, November 2, 2018Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureReversed the trial judgment for the provider because the trial evidence did not establish exhaustion of remedies against the vehicle's owner, making the claim against MVAIC premature.
Forest Park Acupuncture, P.C. v MVAIC (2018 NY Slip Op 50768(U)) Appellate Term, Second Department, May 25, 2018Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established no timely notice of claim was filed and plaintiff showed no leave to file late, so the assignor was not a covered person.
Five Boro Psychological Servs., P.C. v MVAIC (2018 NY Slip Op 50778(U)) Appellate Term, Second Department, May 25, 2018Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is premature (also decides)Held, for the reasons stated in an earlier decision it adopted, that the trial on whether the assignor was a qualified person should have ended in judgment for MVAIC dismissing the complaint.
Medical Diversified Servs., Inc. v MVAIC (2017 NY Slip Op 51848(U)) Appellate Term, Second Department, December 22, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld a timely notice-of-intention affidavit is a condition precedent to covered-person status, and the provider's failure to prove one was submitted required dismissal of the complaint.
GL Acupuncture, P.C. v MVAIC (2017 NY Slip Op 51866(U)) Appellate Term, Second Department, December 22, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established no timely notice of claim was filed, so the assignor was not a covered person and a condition precedent to recovering from MVAIC was unmet.
Tam Med. Supply Corp. v MVAIC (2017 NY Slip Op 51894(U)) Appellate Term, Second Department, December 22, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the owner of the striking vehicle was known, the provider had to exhaust remedies against the owner before seeking MVAIC benefits and did not demonstrate it had done so.
TAM Med. Supply Corp. v MVAIC (2017 NY Slip Op 51831(U)) Appellate Term, Second Department, December 19, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld a timely notice-of-intention affidavit is a condition precedent to covered-person status and MVAIC established it never received one, so its cross motion for dismissal was granted.
New Millennium Med. Imaging, P.C. v MVAIC (2017 NY Slip Op 51833(U)) Appellate Term, Second Department, December 19, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established no timely notice of claim was filed and plaintiff showed no leave to file late, so the assignor was not a covered person and a condition precedent was unmet.
T & S Med. Supply Corp. v MVAIC (2017 NY Slip Op 51755(U)) Appellate Term, Second Department, December 15, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a qualified person because the record showed she was the named insured, and MVAIC also established it never received a timely notice-of-intention affidavit.
Daily Med. Equip. Distrib. Ctr., Inc. v MVAIC (2017 NY Slip Op 51763(U)) Appellate Term, Second Department, December 15, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because no timely notice of claim was filed or leave obtained, and the certified police report showed the hit-and-run was reported over two weeks late without excuse.
Chapa Prods. Corp. v MVAIC (2017 NY Slip Op 51775(U)) Appellate Term, Second Department, December 15, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the identity of the striking vehicle was known, the provider had to exhaust remedies against its owner before seeking MVAIC benefits and did not demonstrate it had done so.
TAM Med. Supply Corp. v MVAIC (2017 NY Slip Op 51777(U)) Appellate Term, Second Department, December 15, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established no timely notice of intention to make claim was filed and plaintiff showed no leave to file late, so the assignor was not a covered person.
Orlin & Cohen Orthopedic Assoc. v Motor Veh. Acc. Indem. Corp. (2017 NY Slip Op 51778(U)) Appellate Term, Second Department, December 15, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld after trial that because the claim forms identified the striking driver, the provider had to exhaust remedies against all potential carriers first and did not demonstrate exhaustion, so judgment went to MVAIC.
TAM Med. Supply Corp. v MVAIC (2017 NY Slip Op 51725(U)) Appellate Term, Second Department, December 8, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established that no timely affidavit of notice of intention to make claim was filed, so the assignor was not a covered person and a condition precedent was unmet.
Compas Med., P.C. v MVAIC (2017 NY Slip Op 51734(U)) Appellate Term, Second Department, December 8, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the assignor testified the van stayed at the scene and its information was written down, the owner and driver may be identifiable and the provider must exhaust remedies against other carriers before claiming against MVAIC.
Tam Med. Supply Corp. v MVAIC (2017 NY Slip Op 51459(U)) Appellate Term, Second Department, October 27, 2017Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established that no timely affidavit giving notice of intention to make claim was filed, so the assignor was not a covered person and a condition precedent was unmet.
Compas Med., P.C. v MVAIC (2017 NY Slip Op 51467(U)) Appellate Term, Second Department, October 27, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the owner of the vehicle carrying the assignor was known, the provider had to exhaust remedies against the owner first and did not demonstrate that it had done so.
Village Med. Supply, Inc. v MVAIC (2017 NY Slip Op 50936(U)) Appellate Term, Second Department, July 21, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is premature (also decides)Held, for reasons adopted from an earlier companion decision, that the trial on whether the assignor was a qualified person should have ended in judgment for MVAIC dismissing the complaint.
Advanced Chiropractic of NY, P.C. v MVAIC (2017 NY Slip Op 50955(U)) Appellate Term, Second Department, July 21, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider failed to show the assignor was a qualified person because it did not establish MVAIC received proof of New York residence or that no other insurance coverage was available.
Daily Med. Equip. Distrib. Ctr., Inc. v MVAIC (2017 NY Slip Op 50039(U)) Appellate Term, Second Department, January 6, 2017Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider did not show it exhausted remedies against the known owner, because a rental company's letter disclaiming no-fault coverage was not dispositive since coverage could be deemed included by statute; MVAIC need not pay first and seek recovery.
3 Star Acupuncture, P.C. v MVAIC (2016 NY Slip Op 51609(U)) Appellate Term, Second Department, November 1, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureAt a trial limited by stipulation to exhaustion, held the provider had to exhaust remedies against the known owner of the vehicle the assignor was in, and directed dismissal because exhaustion was not demonstrated.
Daily Med. Equip. Distrib. Ctr., Inc. v MVAIC (2016 NY Slip Op 51622(U)) Appellate Term, Second Department, November 1, 2016MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held the 30-day determination period ran from receipt of the claims regardless of whether MVAIC had found the claimant a qualified and covered person, so its untimely response precluded defenses subject to preclusion.
B.Y., M.D., P.C. v Motor Veh. Acc. Indem. Corp. (2016 NY Slip Op 51626(U)) Appellate Term, Second Department, November 1, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the providers had to exhaust their remedies against the known owner of the vehicle in which the assignors were passengers, and affirmed dismissal because exhaustion was not demonstrated.
Avicenna Med. Arts, P.L.L.C. v MVAIC (2016 NY Slip Op 51535(U)) Leading case Appellate Term, Second Department, October 11, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider failed to show covered-person status because it did not establish that a timely affidavit giving MVAIC notice of intention to make a claim, a condition precedent, had been submitted.
Right Aid Diagnostic Medicine, P.C. v MVAIC (2016 NY Slip Op 51438(U)) Appellate Term, Second Department, October 5, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle in which the assignor was a passenger, and granted MVAIC dismissal because exhaustion was not demonstrated.
Gerik Acupuncture, P.C. v MVAIC (2016 NY Slip Op 51445(U)) Appellate Term, Second Department, October 5, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that, since the assignor's sworn notice named the vehicle owner and gave a policy number, the provider had to exhaust remedies against that owner, and dismissed because exhaustion was not demonstrated.
Renelique v MVAIC (2016 NY Slip Op 51408(U)) Appellate Term, Second Department, September 27, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle in which the assignor was a passenger, and granted MVAIC dismissal because exhaustion was not demonstrated.
Medcare Supply, Inc. v MVAIC (2016 NY Slip Op 51414(U)) Appellate Term, Second Department, September 27, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle in which the assignor was a passenger, and granted MVAIC dismissal because exhaustion was not demonstrated.
Village Med. Supply, Inc. v MVAIC (2016 NY Slip Op 51421(U)) Appellate Term, Second Department, September 27, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the assignor was not shown to be a qualified and covered person because the provider did not prove MVAIC received proof of New York residence or a timely notice of intention to make claim.
BES Med. Supply, Inc. v MVAIC (2016 NY Slip Op 51427(U)) Appellate Term, Second Department, September 27, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle that struck the assignor's vehicle, and granted MVAIC dismissal because exhaustion was not demonstrated.
Colin Clarke, M.D., P.C. v MVAIC (2016 NY Slip Op 51432(U)) Appellate Term, Second Department, September 27, 2016Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld a timely § 5208 notice-of-intention affidavit is a condition precedent to covered-person status, and granted MVAIC dismissal because it established it had never received such an affidavit.
TAM Med. Supply Corp. v MVAIC (2016 NY Slip Op 51436(U)) Appellate Term, Second Department, September 27, 2016Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of intention was filed and the provider showed no application for leave to file late.
Compas Med., P.C. v MVAIC (2016 NY Slip Op 51355(U)) Appellate Term, Second Department, September 19, 2016Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld an issue of fact existed on whether benefits from another household member's insurer had to be exhausted, because the assignor's household affidavit swore she lived alone, contradicting MVAIC's claim representative.
Yklik, Inc. v Mvaic (2016 NY Slip Op 50874(U)) Appellate Term, Second Department, June 3, 2016Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider did not establish covered-person status because it failed to prove submission of a timely notice of intention to make a claim, a condition precedent to recovery from MVAIC.
Apollo Chiropractic Care, P.C. v MVAIC (2016 NY Slip Op 50212(U)) Appellate Term, Second Department, February 23, 2016Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC's lack-of-coverage defense based on no notice of intention was not precluded by misaddressed verification requests, and remitted because the stipulated facts did not show whether the assignor was a covered person.
Advanced Med. Diagnostics of Queens, P.C. v Mvaic (2015 NY Slip Op 51659(U)) Appellate Term, Second Department, November 12, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureAfter a trial on coverage, held the provider had to exhaust remedies against the known owner of the vehicle the assignor was in, and directed dismissal because it did not demonstrate exhaustion.
SK Prime Med. Supply, Inc. v MVAIC (2015 NY Slip Op 51663(U)) Appellate Term, Second Department, November 12, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider failed to show the assignor was a covered person because it did not prove MVAIC received proof of New York residence or that a notice of intention to make claim was submitted.
T & J Chiropractic, P.C. v MVAIC (2015 NY Slip Op 51445(U)) Appellate Term, Second Department, September 28, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle that struck the assignor, and affirmed dismissal because it did not demonstrate exhaustion.
Ultimate Health Prods., Inc. v MVAIC (2015 NY Slip Op 51446(U)) Appellate Term, Second Department, September 28, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle in which the assignor rode, and affirmed dismissal because it did not demonstrate exhaustion.
Pierre J. Renelique, M.D., P.C. v MVAIC (2015 NY Slip Op 51233(U)) Appellate Term, Second Department, August 5, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle in which the assignor was a passenger, and affirmed dismissal because it did not demonstrate exhaustion.
XVV, Inc. v MVAIC (2015 NY Slip Op 50771(U)) Appellate Term, Second Department, May 18, 2015Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established that no timely notice of claim was filed and leave to file a late notice was never sought.
Compas Med., P.C. v MVAIC (2015 NY Slip Op 50774(U)) Appellate Term, Second Department, May 18, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle that struck the assignor, and granted MVAIC dismissal because exhaustion was not demonstrated.
Queens Med. Supply, Inc. v MVAIC (2015 NY Slip Op 50775(U)) Appellate Term, Second Department, May 18, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that, since the assignor's sworn notice identified the vehicle that struck her, the provider had to exhaust remedies against its owner, and reversed the trial judgment because exhaustion was not demonstrated.
East Gun Hill Med., P.C. v MVAIC (2015 NY Slip Op 50409(U)) Appellate Term, Second Department, March 17, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle that struck the assignor before suing MVAIC, and dismissed because it did not demonstrate exhaustion.
Compas Med., P.C. v MVAIC (2015 NY Slip Op 50395(U)) Appellate Term, Second Department, March 16, 2015MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's failure-to-exhaust argument because MVAIC offered no admissible evidence that the assignor was entitled to benefits under an existing policy, so it failed to raise a triable issue.
East Gun Hill Med., P.C. v MVAIC (2015 NY Slip Op 50398(U)) Appellate Term, Second Department, March 16, 2015Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established that no timely notice of claim was filed and no leave to file late was sought, so the condition precedent failed.
Delta Diagnostic Radiology, P.C. v MVAIC (2015 NY Slip Op 50385(U)) Appellate Term, Second Department, March 12, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld after trial that the provider, having enough information to identify the owner of the Pennsylvania vehicle in which the assignor rode, had to exhaust remedies against that owner and did not demonstrate it had done so.
Advanced Chiropractic of NY, P.C. v MVAIC (2015 NY Slip Op 50386(U)) Appellate Term, Second Department, March 12, 2015Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust its remedies against the known owner of the vehicle in which the assignor rode before seeking relief from MVAIC, and dismissed because it did not demonstrate exhaustion.
Optimal Well-Being Chiropractic, P.C. v MVAIC (2014 NY Slip Op 51861(U)) Appellate Term, Second Department, December 19, 2014MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held MVAIC's payment untimely, so interest and attorney's fees accrued, because the 30-day period runs without waiting for MVAIC to qualify the injured person.
Central Radiology Servs., P.C. v MVAIC (2014 NY Slip Op 24402) Appellate Term, Second Department, December 17, 2014Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC's lack-of-coverage defense not subject to preclusion and, because the stipulated facts did not show whether the notice of intention was sworn or stated New York residence, remitted for trial on residency.
Complete Spinal Physical Therapy & Chiropractic, PLLC v MVAIC (2014 NY Slip Op 51811(U)) Appellate Term, Second Department, December 17, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle in which the assignor was a passenger, did not demonstrate that it had exhausted its remedies against that owner.
Optimal Well-Being Chiropractic, P.C. v MVAIC (2014 NY Slip Op 51816(U)) Appellate Term, Second Department, December 17, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle the assignor drove, did not demonstrate that it had exhausted its remedies against that owner.
Optimal Well-Being Chiropractic, P.C. v MVAIC (2014 NY Slip Op 51817(U)) Appellate Term, Second Department, December 17, 2014Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so a condition precedent was unmet and the complaint was dismissed.
Optimal Well-Being Chiropractic, P.C. v MVAIC (2014 NY Slip Op 51818(U)) Appellate Term, Second Department, December 17, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle that struck the assignor, did not demonstrate that it had exhausted its remedies against that owner.
Jamaica Med. Supply, Inc. v MVAIC (2014 NY Slip Op 51823(U)) Appellate Term, Second Department, December 17, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle that struck the assignor, did not demonstrate that it had exhausted its remedies against that owner.
Delta Diagnostic Radiology, P.C. v MVAIC (2014 NY Slip Op 51261(U)) Appellate Term, Second Department, August 8, 2014Court finds the claimant qualified/covered, or the condition met or excused, on the claimant's own proofRejected MVAIC's residency objection as lacking merit because it received a notarized notice of intention and a police report both giving the assignor's New York residence, so no further documentary proof was required.
Yklik, Inc. v MVAIC (2014 NY Slip Op 50961(U)) Appellate Term, Second Department, May 29, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle the assignor drove, did not demonstrate that it had exhausted its remedies against that owner.
East Gun Hill Med., P.C. v MVAIC (2014 NY Slip Op 50965(U)) Appellate Term, Second Department, May 29, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle in which the assignor was a passenger, did not demonstrate that it had exhausted its remedies against that owner.
Orthopro Servs., Inc. v MVAIC (2014 NY Slip Op 50463(U)) Appellate Term, Second Department, March 17, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle the assignor drove, did not demonstrate that it had exhausted its remedies against that owner.
Compas Med., P.C. v MVAIC (2014 NY Slip Op 50465(U)) Appellate Term, Second Department, March 17, 2014Court finds the claimant qualified/covered, or the condition met or excused, on the claimant's own proofHeld the assignor's sworn notice of intention giving a New York residence and the same-day police report of the hit-and-run showed covered-person status, and MVAIC's later statement did not establish nonresidence.
Compas Med., P.C. v MVAIC (2014 NY Slip Op 50414(U)) Appellate Term, Second Department, March 11, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld after trial that, because the provider and assignor knew the owner of the vehicle the assignor drove, the provider had to exhaust remedies against the owner and did not demonstrate it had done so.
Healing Art Acupuncture, P.C. v MVAIC (2014 NY Slip Op 50422(U)) Appellate Term, Second Department, March 11, 2014Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC summary judgment because the provider, knowing the owner of the vehicle the assignor drove, did not demonstrate that it had exhausted its remedies against that owner.
All Boro Psychological Servs., P.C. v MVAIC (2013 NY Slip Op 51744(U)) Appellate Term, Second Department, October 15, 2013Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider, aware of the owner of the vehicle the assignor was driving, had to exhaust remedies against that owner before seeking benefits and did not demonstrate exhaustion, so dismissal was affirmed.
Shore Med. Diagnostic, P.C. v MVAIC (2013 NY Slip Op 51749(U)) Appellate Term, Second Department, October 15, 2013Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so a condition precedent was unmet and the complaint was dismissed.
Optimal Well-Being Chiropractic, P.C v MVAIC (2013 NY Slip Op 51751(U)) Appellate Term, Second Department, October 15, 2013Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureGranted MVAIC dismissal because the hit-and-run bicyclist was never shown to have filed the required 24-hour accident report. Nor was there any showing that filing one was not reasonably possible, so the assignor was not a covered person.
Ranbow Supply of N.Y., Inc. v MVAIC (2013 NY Slip Op 51732(U)) Appellate Term, Second Department, October 8, 2013Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureReversed a trial judgment finding coverage, holding the provider had to exhaust remedies against the known owner of the vehicle in which the assignor rode and did not demonstrate it had done so.
Metropolitan Med. Supplies, LLC v MVAIC (2013 NY Slip Op 51735(U)) Appellate Term, Second Department, October 8, 2013Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider, knowing the owner of the vehicle that struck the assignor, was required to exhaust remedies against that owner first and did not demonstrate exhaustion, so MVAIC was entitled to dismissal.
Post Traumatic Med. Care, P.C. v Motor Veh. Acc. Indem. Corp. (2013 NY Slip Op 51747(U)) Appellate Term, Second Department, October 8, 2013Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld the provider not entitled to summary judgment or dismissal of the lack-of-coverage defense because a triable issue of fact on coverage remained, the provider not having shown it exhausted remedies against the vehicle's owner.
Metropolitan Med. Supplies, LLC v MVAIC (2013 NY Slip Op 51583(U)) Appellate Term, Second Department, September 26, 2013Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider, aware of the identity of the owner of the vehicle that struck the assignor, had to exhaust remedies against that owner and did not demonstrate it had, so MVAIC was granted dismissal.
Metropolitan Med. Supplies, Inc. v MVAIC (2013 NY Slip Op 50257(U)) Appellate Term, Second Department, February 19, 2013Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave was sought to file late, so a condition precedent to benefits was unmet.
Olmecs Med. Supplies, Inc. v MVAIC (2013 NY Slip Op 50218(U)) Appellate Term, Second Department, January 30, 2013Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider did not show its assignor was eligible for MVAIC benefits because it offered no proof that a timely sworn notice of intention to make a claim, a condition precedent to covered-person status, was submitted.
Brooklyn Hgts. Physical Therapy, P.C v MVAIC (2012 NY Slip Op 51774(U)) Appellate Term, Second Department, September 6, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established that no timely notice of claim was filed and no leave to file late was sought, so MVAIC was entitled to dismissal.
3 Star Acupuncture, P.C. v MVAIC (2012 NY Slip Op 51708(U)) Appellate Term, Second Department, August 31, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider had to exhaust remedies against the known owner of the vehicle in which the assignor rode and, having not demonstrated exhaustion, could not recover from MVAIC.
Five Boro Psychological Servs., P.C. v MVAIC (2012 NY Slip Op 51709(U)) Appellate Term, Second Department, August 31, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider, aware of the vehicle owner's identity, was required to exhaust remedies against the owner first and had not demonstrated doing so, so MVAIC's dismissal motion was properly granted.
Ranbow Supply of N.Y., Inc. v MVAIC (2012 NY Slip Op 51719(U)) Appellate Term, Second Department, August 31, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and leave to file late was never sought, defeating a condition precedent to recovery.
David v MVAIC (2012 NY Slip Op 51721(U)) Appellate Term, Second Department, August 31, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC could raise the provider's failure to exhaust remedies against the known owner despite an earlier ruling, but it failed to raise a triable issue because it did not attach the documents it relied on.
Jamhil Med., P.C. v MVAIC (2012 NY Slip Op 51650(U)) Appellate Term, Second Department, August 24, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so a condition precedent to recovery was unmet.
First Help Acupuncture, P.C. v MVAIC (2012 NY Slip Op 51643(U)) Appellate Term, Second Department, August 23, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the hit-and-run assignor not shown to be a covered person because the provider offered no indication the accident was reported within 24 hours after MVAIC said proof was repeatedly requested, nor any showing reporting was not reasonably possible.
Central Radiology Servs., P.C. v MVAIC (2012 NY Slip Op 51624(U)) Appellate Term, Second Department, August 7, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's argument that the assignor was not a qualified person for failing to provide a household affidavit, because qualified status does not depend on MVAIC's receipt of that affidavit.
D & R Med. Supply, Inc. v MVAIC (2012 NY Slip Op 51625(U)) Appellate Term, Second Department, August 7, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the owner of the vehicle that struck the assignor, exhaustion of remedies against that owner was required, and the provider did not demonstrate it.
Mosad Med., P.C. v MVAIC (2012 NY Slip Op 51632(U)) Appellate Term, Second Department, August 7, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the owner of the vehicle that struck the assignor's vehicle, exhaustion of remedies against that owner was required, and the provider did not demonstrate it.
Vladenn Med. Supply Corp. v MVAIC (2012 NY Slip Op 51491(U)) Appellate Term, Second Department, August 6, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the owner of the vehicle that struck the assignor's vehicle, exhaustion of remedies against that owner was required, and the provider did not demonstrate it.
Allstate Social Work & Psychological Svcs, P.L.L.C. v MVAIC (2012 NY Slip Op 51498(U)) Appellate Term, Second Department, August 6, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's residency objection because its own papers included the sworn notice of claim and household affidavit giving a Brooklyn address, and its demand for further documentary proof lacked merit.
Brooklyn Hgts. Physical Therapy, P.C. v MVAIC (2012 NY Slip Op 51500(U)) Appellate Term, Second Department, August 6, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so MVAIC was granted summary judgment.
Yklik, Inc. v MVAIC (2012 NY Slip Op 51012(U)) Appellate Term, Second Department, May 14, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely sworn notice of claim or leave to file late, and additionally that remedies against the known vehicle owner were not exhausted.
Central Radiology Servs., P.C. v MVAIC (2012 NY Slip Op 50875(U)) Appellate Term, Second Department, May 11, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so a condition precedent to benefits was unmet.
Central Radiology Servs., P.C. v MVAIC (2012 NY Slip Op 50877(U)) Appellate Term, Second Department, May 11, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the owner of the vehicle in which the assignor rode, exhaustion of remedies against that owner was required, and the provider's failure to show it defeated the claim.
Five Boro Psychological Servs., P.C. v MVAIC (2012 NY Slip Op 50878(U)) Appellate Term, Second Department, May 11, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so dismissal of the complaint was proper.
Alpha Psychological Assessment, P.C. v MVAIC (2012 NY Slip Op 50879(U)) Appellate Term, Second Department, May 11, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so a condition precedent to benefits was not satisfied.
Ortho Pro Servs., Inc. v MVAIC (2012 NY Slip Op 50881(U)) Appellate Term, Second Department, May 11, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the owner of the vehicle that struck the assignor, exhaustion of remedies against that owner was required, and the provider did not demonstrate it.
Parsons Med. Supply, Inc. v MVAIC (2012 NY Slip Op 50750(U)) Appellate Term, Second Department, April 25, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that an assignor injured as an ambulette passenger had to exhaust remedies against the vehicle's owner first, and since the provider did not demonstrate exhaustion, MVAIC was granted summary judgment.
Five Boro Psychological Servs., P.C. v MVAIC (2012 NY Slip Op 50751(U)) Appellate Term, Second Department, April 25, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so a condition precedent to benefits failed.
Farragut Med., P.C. v MVAIC (2012 NY Slip Op 50754(U)) Appellate Term, Second Department, April 25, 2012Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld that although the provider had to exhaust remedies against the known owner, it raised an issue of fact as to whether those remedies had been exhausted, so MVAIC was denied summary judgment.
3 Star Acupuncture, P.C. v MVAIC (2012 NY Slip Op 50756(U)) Appellate Term, Second Department, April 25, 2012Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established no timely notice of claim was filed and no leave to file late was sought, so the complaint was dismissed.
Tongren Acupuncturist, P.C. v MVAIC (2012 NY Slip Op 50418(U)) Appellate Term, Second Department, March 6, 2012Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the owner of the vehicle in which the assignor rode, the provider had to exhaust remedies against that owner and, not having shown exhaustion, lost to MVAIC's summary judgment motion.
Palin Winotaka, L.Ac. v Mvaic (2012 NY Slip Op 50391(U)) Appellate Term, Second Department, March 2, 2012Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld the provider showed an issue of fact as to whether its remedies against the known owner of the vehicle the assignor rode in had been exhausted, so MVAIC was not entitled to summary judgment.
Intuitive Chiropractic, P.C. v MVAIC (2012 NY Slip Op 50147(U)) Appellate Term, Second Department, January 24, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's contention that the assignor was not a qualified person for failing to provide a household affidavit or proof of no insurance, because qualified status does not depend on MVAIC's receipt of those documents.
Whole Health Acupuncture, P.C. v MVAIC (2011 NY Slip Op 52368(U)) Appellate Term, Second Department, December 23, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider, knowing the owner of the vehicle in which the assignor rode, had to exhaust remedies against that owner and failed to demonstrate exhaustion, so MVAIC's summary judgment motion should have been granted.
Velen Med. Supply v MVAIC (2011 NY Slip Op 52016(U)) Appellate Term, Second Department, October 27, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the hit-and-run assignor not shown to be a covered person because the provider gave no indication the accident was reported within 24 hours, nor any showing that reporting was not reasonably possible.
BLR Chiropractic, P.C. v MVAIC (2011 NY Slip Op 51878(U)) Appellate Term, Second Department, October 18, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the owner of the vehicle the assignor rode in, the provider had to exhaust remedies against that owner and, having not shown exhaustion, its claim was dismissed.
Peace of Mind, Social Work, P.C. v MVAIC (2011 NY Slip Op 51834(U)) Appellate Term, Second Department, October 11, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider failed to show the assignor was a covered person because it did not establish that a timely notice of intention to make claim, a condition precedent, was submitted to MVAIC.
Complete Med. Servs. of NY, P.C. v MVAIC (2011 NY Slip Op 51835(U)) Appellate Term, Second Department, October 11, 2011Court finds the claimant qualified/covered, or the condition met or excused, on the claimant's own proofHeld the assignor's residency shown because MVAIC received her notarized notice of intention to make claim, executed the day after the accident, which set forth her New York residence.
Turnpike Med., P.C. v MVAIC (2011 NY Slip Op 51717(U)) Appellate Term, Second Department, September 16, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's contention that the assignor was not a qualified person for failing to provide written proof of lack of insurance, because qualified status does not depend on MVAIC's receipt of such documents.
Farragut Corner Medical, P.C. v MVAIC (2011 NY Slip Op 51529(U)) Appellate Term, Second Department, August 4, 2011MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's objection that the assignor was not a qualified person for lack of a household affidavit, because qualified status does not depend on MVAIC receiving that affidavit.
Ap Orthopedic & Rehabilitation, P.C. v Mvaic (2011 NY Slip Op 51448(U)) Appellate Term, Second Department, July 28, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the assignor was not a qualified or covered person because she never gave MVAIC proof of New York residency, and the provider also failed to exhaust remedies against the known owner of the striking vehicle.
Sanli Acupuncture, P.C. v MVAIC (2011 NY Slip Op 51231(U)) Appellate Term, Second Department, June 30, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider did not show it exhausted remedies against the known owner of the striking vehicle, noting that the driver's charge for driving uninsured did not prove the vehicle was uninsured.
Five Boro Psychological Servs., P.C. v MVAIC (2011 NY Slip Op 50989(U)) Appellate Term, Second Department, May 26, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider, aware of the identity of the owner of the vehicle that struck the assignor, did not show it exhausted remedies against that owner, so MVAIC's motion should have been granted.
B.Y., M.D., P.C. v Motor Veh. Acc. Indem. Corp. (2011 NY Slip Op 50984(U)) Appellate Term, Second Department, May 24, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the providers, aware of the identity of the owner of the vehicle that struck the assignor, had to exhaust remedies against that owner and, having not shown it, lost their motion while MVAIC's was granted on search of the record.
Five Boro Psychological Servs., P.C. v MVAIC (2011 NY Slip Op 50627(U)) Appellate Term, Second Department, April 11, 2011Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld the police report identifying the insurer of the vehicle the assignor rode in raised a triable issue whether the provider had exhausted remedies against the owner, so the provider's summary judgment motion was denied.
Nature Acupuncture, P.C. v MVAIC (2011 NY Slip Op 50633(U)) Appellate Term, Second Department, April 11, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the providers and assignor knew the identity of the owner of the vehicle the assignor rode in, they had to exhaust remedies against the owner, and having not shown exhaustion, MVAIC's motion was granted.
Central Radiology Servs., P.C. v MVAIC (2011 NY Slip Op 50617(U)) Appellate Term, Second Department, April 6, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignors knew who owned the vehicle they rode in, the provider had to exhaust remedies against the owner, and having not shown exhaustion it lost to MVAIC's motion.
Larisa Supplies, Inc. v MVAIC (2011 NY Slip Op 50562(U)) Appellate Term, Second Department, March 29, 2011Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established that no timely notice of claim was filed and no leave to file late was sought, so a condition precedent to MVAIC benefits failed.
South Nassau Orthopedic Surgery & Sports Medicine, P.C. v MVAIC (2011 NY Slip Op 50028(U)) Appellate Term, Second Department, January 10, 2011Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the assignee had to exhaust its remedies against the owner of the vehicle in which the assignor rode before seeking relief from MVAIC, so its claim was premature and MVAIC's motion was granted.
Central Radiology Servs., P.C. v MVAIC (2010 NY Slip Op 51454(U)) Appellate Term, Second Department, August 12, 2010Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not shown to be a covered person because MVAIC's claim representative affidavit showed prima facie that no timely notice of claim was filed and the provider showed neither timely filing nor a request for leave to file late.
Five Boro Psychological Servs., P.C. v MVAIC (2010 NY Slip Op 51348(U)) Appellate Term, Second Department, July 29, 2010Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider not entitled to summary judgment because, knowing the owners of the vehicles involved, it had to exhaust remedies against them first and the record did not show it had done so.
AR Med. Rehabilitation, P.C. v MVAIC (2010 NY Slip Op 51349(U)) Appellate Term, Second Department, July 29, 2010Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld MVAIC entitled to summary judgment because the provider, knowing the striking vehicle's owner, had to exhaust its remedies against that owner and offered no proof that it had done so.
Five Boro Psychological Servs., P.C. v MVAIC (2010 NY Slip Op 51250(U)) Appellate Term, Second Department, July 16, 2010Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider not entitled to summary judgment because timely filing of the notice of intention is a condition precedent it had to establish to show covered-person status, and MVAIC's untimely denial was of no consequence.
Parkway Anesthesia Assoc., PLLC v MVAIC (2010 NY Slip Op 50713(U)) Appellate Term, Second Department, April 16, 2010Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC showed prima facie that no timely notice of claim was filed and the provider showed neither timely or prompt filing nor that leave to file late was sought.
Staten Is. Chiropractic Assoc., PLLC v MVAIC (2010 NY Slip Op 50698(U)) Appellate Term, Second Department, April 13, 2010Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew who owned the striking vehicle, the provider had to exhaust its remedies against that owner first, and until it did so its claim against MVAIC was premature.
Five Boro Psychological Servs., P.C. v MVAIC (2010 NY Slip Op 50647(U)) Appellate Term, Second Department, April 9, 2010Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC established that no timely notice of claim was filed and no leave to file late was sought, and it was not given proof of New York residence.
Five Boro Psychological Servs., P.C. v MVAIC (2010 NY Slip Op 50641(U)) Appellate Term, Second Department, April 8, 2010Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld that because the provider and assignor knew the vehicle owner's identity, the provider had to exhaust remedies against the owner before suing, so conditioning dismissal on proof of lack of insurance placed no improper burden on it.
Fatiha Ibrahim, D.C. v MVAIC (2009 NY Slip Op 52125(U)) Appellate Term, Second Department, October 19, 2009MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to make a prima facie showing that the provider had not exhausted remedies against the known vehicle owner, because its claims examiner's affidavit was incomplete and lacked personal knowledge.
RAZ Acupuncture, P.C. v MVAIC (2009 NY Slip Op 52362(U)) Appellate Term, Second Department, August 31, 2009Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC entitled to dismissal because its papers showed, prima facie and unrebutted, that the assignor, who gave no proof of New York residency, was not a qualified and therefore not a covered person; the defense was not precludable.
Meridian Health Acupuncture, P.C. v MVAIC (2009 NY Slip Op 50440(U)) Appellate Term, Second Department, March 12, 2009Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the hit-and-run pedestrian not a covered person because nothing showed the required 24-hour accident report was filed or excused, and held the lack-of-coverage defense survived MVAIC's untimely denial.
M.N.M. Med. Health Care, P.C. v MVAIC (2009 NY Slip Op 50041(U)) Appellate Term, Second Department, January 9, 2009Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC entitled to dismissal because it showed the assignor failed to file a timely notice of claim, a condition precedent to covered-person status, and the defaulting provider showed no timely filing or leave to file late.
Modern Art Med., P.C. v MVAIC (2008 NY Slip Op 52586(U)) Leading case Appellate Term, Second Department, December 31, 2008Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider not entitled to summary judgment because it knew the vehicle owner's identity and did not demonstrate that it had exhausted its remedies against that owner before seeking benefits from MVAIC.
Doctor Liliya Med., P.C. v MVAIC (2008 NY Slip Op 52453(U)) Appellate Term, Second Department, December 3, 2008Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the claim premature and dismissed it because the provider and assignor knew the driver and owner of the vehicle carrying the assignor and had not exhausted remedies against them before seeking MVAIC benefits.
Dr. Abakin, D.C., P.C. v MVAIC (2008 NY Slip Op 52186(U)) Appellate Term, Second Department, November 5, 2008Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the action premature and properly dismissed because the provider and assignor knew the driver and owner of the vehicle in which the assignor was a passenger and had not exhausted remedies against them.
Greater Health Through Chiropractic, P.C. v MVAIC (2008 NY Slip Op 52178(U)) Appellate Term, Second Department, October 31, 2008MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC's motion properly denied because it submitted insufficient evidence that the vehicle the assignor was using or operating was a motorcycle, which would have made her ineligible.
Howard M. Rombon, Ph.D, P.C. v MVAIC (2008 NY Slip Op 52128(U)) Appellate Term, Second Department, October 27, 2008Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld that an issue of fact existed whether the assignor, who allegedly gave no proof of New York residency, was a qualified and therefore covered person, and that MVAIC's untimely denial did not preclude the lack-of-coverage defense.
Complete Med. Servs. of NY, P.C. v MVAIC (2008 NY Slip Op 51864(U)) Appellate Term, Second Department, September 3, 2008Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the claim premature, granting MVAIC dismissal, because the provider knew the identity of the striking vehicle's owner and had not exhausted its remedies against that owner.
Island Surgical Supply Co., Inc. v MVAIC (2008 NY Slip Op 51860(U)) Appellate Term, Second Department, September 2, 2008Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the claim premature because the provider and assignor knew the owner of the vehicle the assignor was driving and had not exhausted remedies against that owner before seeking benefits from MVAIC.
Complete Med. Servs., P.C. v MVAIC (2008 NY Slip Op 28269) Appellate Term, Second Department, July 10, 2008MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC's qualified-person objection meritless because the assignor's status does not depend on MVAIC's receipt of a police report and the record did not support noncompliance with article 52 reporting requirements.
Liberty Orthopedics, PLLC v Mvaic (2008 NY Slip Op 51533(U)) Appellate Term, Second Department, July 10, 2008MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointRejected MVAIC's argument that the assignor was not a qualified person for failing to provide a household affidavit or proof of no insurance, because qualified status does not depend on MVAIC's receipt of those documents.
Complete Med. Servs. of N.Y., P.C. v MVAIC (2008 NY Slip Op 51541(U)) Appellate Term, Second Department, July 10, 2008Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the claim premature because the provider and assignor knew the taxicab's driver and owner and had to exhaust remedies against them before seeking benefits from MVAIC, so MVAIC's cross motion was granted.
Rj Professional Acupuncturist, P.C. v MVAIC (2008 NY Slip Op 51472(U)) Appellate Term, Second Department, April 29, 2008MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held MVAIC's 30-day period was not suspended while it sought verification to determine whether the assignor was a qualified person, so its untimely qualification requests did not make the claims premature.
Astoria Quality Med. Supply v MVAIC (2007 NY Slip Op 52275(U)) Appellate Term, Second Department, November 20, 2007MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld dismissal of one assignor's claim for noncompliance with the notice-of-claim condition was error because the record did not support a finding that the assignee failed to comply with that condition precedent.
Bell Air Med. Supply, LLC v MVAIC (2007 NY Slip Op 51607(U)) Appellate Term, Second Department, August 16, 2007Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld two assignors were not covered persons because the record showed they neither filed a timely notice of claim nor sought leave to file late, but found no such failure shown for the third assignor.
GMV Med. Supplies, Inc. v MVAIC (2007 NY Slip Op 50601(U)) Appellate Term, Second Department, March 26, 2007MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverRejected MVAIC's qualified-person ground because the 30-day pay-or-deny period ran from receipt of the claim regardless of whether MVAIC had deemed the injured person qualified, and MVAIC showed no timely verification tolling it.
Englinton Med., P.C. v MVAIC (2007 NY Slip Op 50164(U)) Appellate Term, Second Department, January 31, 2007MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverHeld MVAIC precluded from contesting qualified-person status because the 30-day period ran from receipt of the claim regardless of qualification and MVAIC neither denied nor validly requested verification in time.
A.B. Med. Servs. PLLC v Motor Veh. Acc. Indem. Corp. (2006 NY Slip Op 50139(U)) Appellate Term, Second Department, February 3, 2006Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld two assignors were not covered persons because MVAIC showed they filed no notice of claim within 180 days nor sought leave, plaintiffs raised no issue of fact, and MVAIC's late denial did not preclude the coverage defense.
Ocean Diagnostic Imaging v Motor Veh. Acc. Indem. Corp. (2005 NY Slip Op 51271(U)) Leading case Appellate Term, Second Department, July 28, 2005Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because the record showed no timely notice of claim and no application for leave to file late, and MVAIC's untimely denial did not matter since it rested on lack of coverage.
A.B. Med. Servs. PLLC v Motor Veh. Acc. Indem. Corp. (2005 NY Slip Op 50088(U)) Appellate Term, Second Department, February 1, 2005MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Noted that MVAIC's 30-day period ran from receipt of the proof of claim, not from when it qualified the injured person, so its untimely response precluded its 45-day and medical-necessity defenses.

Trial courts in the First Department (5 decisions)

Westchester Radiology & Imaging, P.C. v MVAIC (2023 NY Slip Op 51516(U)) Civil Court of the City of New York, Bronx County, September 26, 2023Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the claim premature because, the offending Postal Service vehicle's owner being known, the claimant had to exhaust the federal administrative claim remedy first and the record showed no denial of such a claim.
Right Aid Med. Supply Corp. v MVAIC (2020 NY Slip Op 50882(U)) Civil Court of the City of New York, New York County, July 28, 2020Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureDismissed the action as premature because, with the striking vehicle's license plate known, the provider offered no evidence of any effort to identify and exhaust remedies against the owner or operator before claiming against MVAIC.
Metro 8 Med. Equip. Inc. v MVAIC (2019 NY Slip Op 51841(U)) Civil Court of the City of New York, New York County, August 16, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundAfter trial, found on credited testimony that MVAIC never received a signed, notarized notice of intention to make a claim, so the assignor was not a qualified person and the complaint was dismissed.
Vision Rehab PT PC v MVAIC (2019 NY Slip Op 51206(U)) Civil Court of the City of New York, Bronx County, July 29, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a qualified or covered person because the notice of intention was filed months after the 90-day period with no timely leave application, and that the late denial did not preclude this lack-of-coverage defense.
Family Care Acupuncture, P.C. v Motor Veh. Acc. Indem. Corp. (2010 NY Slip Op 51414(U)) Civil Court of the City of New York, New York County, August 6, 2010Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because its examiner's unrebutted affidavit showed no notice of intention, police report or household affidavit was received, so the assignor never became a qualified, covered person; the defense was not precludable.

Trial courts in the Second Department (28 decisions)

KN Acupuncture, PC v MVAIC (2026 NY Slip Op 50620(U)) Civil Court of the City of New York, Kings County, April 30, 2026Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC established that the vehicle was insured at the time of the accident, relying on the insurance card entries in an uncertified police report, and plaintiff offered no rebuttal, so the action was dismissed for available coverage.
Matter of Sampilov v Motor Veh. Acc. Indem. Corp. (2026 NY Slip Op 50312(U)) Supreme Court, Kings County, March 13, 2026Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the petitioner was not a qualified person because the hit-and-run accident was not reported to police or DMV within 24 hours, the MV-104 being filed twelve days later, and shock or unfamiliarity was no legally sufficient excuse.
Good Time Acupuncture, PC v MVAIC (2024 NY Slip Op 50979(U)) Civil Court of the City of New York, Kings County, July 29, 2024Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedDenied MVAIC's summary judgment motion on the assignor's notice-of-claim compliance, rejecting a strict-compliance standard in favor of reasonable compliance and sending the partial-compliance and excuse questions to trial.
Active Care Med. Supply, Corp. v MVAIC (2022 NY Slip Op 22284) Civil Court of the City of New York, Kings County, July 18, 2022Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld after trial that the provider bore the burden of showing the assignor reported the accident to police within 24 hours or was excused, and having offered no such evidence it failed to prove covered-person status.
Advanced Recovery E. & S. v MVAIC (2021 NY Slip Op 51035(U)) Civil Court of the City of New York, Queens County, November 1, 2021Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld MVAIC's records search showed the assignor filed no notice of claim and no timely accident report, so he was not a covered qualified person, and the defense was not precluded by MVAIC's failure to pay or deny.
Masigla v MVAIC (2020 NY Slip Op 51612(U)) Civil Court of the City of New York, Kings County, May 3, 2021MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointAfter trial, held MVAIC failed to prove by admissible evidence that the assignor was a de facto owner of the uninsured vehicle, because the assignor's EUO transcript was inadmissible hearsay against the assignee.
Sabas v MVAIC (2021 NY Slip Op 50313(U)) Civil Court of the City of New York, Queens County, April 15, 2021MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to show the assignor was not a qualified person because status does not depend on its receipt of proof of no insurance, its investigator account was hearsay, and its DMV abstract lacked foundation.
Blackman Pelham Med., P.C. v MVAIC (2020 NY Slip Op 51406(U)) Civil Court of the City of New York, Kings County, November 18, 2020MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiver (also decides)Held MVAIC's denials untimely because the 30-day period ran from receipt of the bills regardless of when MVAIC deemed the assignor qualified, so outstanding qualification requests did not toll it.

Show all 28 decisions

Matter of Haskins v Motor Veh. Acc. Indem. Corp. (2019 NY Slip Op 51417(U)) Supreme Court, Kings County, August 30, 2019Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureDenied as premature the injured bicyclist's petition to compel MVAIC to pay no-fault benefits because, although the police report and timely notice satisfied section 5208, he had not exhausted remedies against the known owner and driver.
Sama Physical Therapy v MVAIC (2019 NY Slip Op 29218) Civil Court of the City of New York, Queens County, July 15, 2019MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverHeld that MVAIC's defense that the assignor was not a qualified person was subject to preclusion, not a coverage exception; because MVAIC did not timely request EUOs or deny the claims, it was precluded and the provider recovered.
Advanced Recovery Equip. & Supplies, LLC v Motor Veh. Indem. Corp. (2019 NY Slip Op 50590(U)) Civil Court of the City of New York, Kings County, April 15, 2019Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor not a covered person because no timely notice of intention to make a claim was filed despite MVAIC's requests, and MVAIC's untimely denial did not preclude this lack-of-coverage defense.
A.C. Med. P.C. v MVAIC (2018 NY Slip Op 51533(U)) Civil Court of the City of New York, Kings County, February 16, 2018Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundGranted MVAIC summary judgment because its qualifications examiner showed the assignor had coverage from the offending vehicle, insured in Mississippi per the police report, and no exhaustion of remedies against the identified owner was shown; the coverage defense was not precludable.
MB Advanced Equip., Inc. v MVAIC (2015 NY Slip Op 25199) Civil Court of the City of New York, Kings County, June 1, 2015Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a qualified or covered person because he never submitted the notice of intention to make a claim, and the assignee provider bore that obligation despite MVAIC sending its requests only to it.
Canon Chiropractic P.C. v MVAIC (2013 NY Slip Op 52044(U)) Civil Court of the City of New York, Kings County, November 22, 2013Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundFound after trial that the assignor never submitted a notarized notice of intention, police report or other qualifying items, so he was not a covered person; the provider, whose bills gave the wrong address, bore that failure.
Lexington Acupuncture, PC v MVAIC (2012 NY Slip Op 51960(U)) Civil Court of the City of New York, Kings County, October 9, 2012MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverHeld MVAIC's letters seeking to determine whether the assignor was a qualified person must meet the verification time frames, because qualified-person status is not a non-precludable lack-of-coverage defense, and MVAIC bears the burden on it.
Matter of Portillo v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 51227(U)) Supreme Court, Queens County, July 5, 2012Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld that the 24-hour report could be satisfied by a timely MV-104 to DMV, but whether it was actually filed within 24 hours required a credibility hearing; residency was found sufficiently shown.
Exclusive Med. Supply, Inc. v MVAIC (2012 NY Slip Op 50616(U)) Civil Court of the City of New York, Kings County, April 11, 2012MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld MVAIC failed to meet its burden of proving the assignor was not a qualified person, because its suspicions that the assignor owned the vehicle or drove it stolen or without consent were speculative and unsupported.
Motor Veh. Acc. Indem. Corp. v Physical Medicine & Rehab of NY (2011 NY Slip Op 50848(U)) Supreme Court, Queens County, May 13, 2011Court finds the claimant qualified/covered, or the condition met or excused, on the claimant's own proofHeld the assignor was a covered person because, under Florida law, the owner's insurer validly rescinded the policy ab initio for a material garaging misrepresentation, so no other coverage existed and MVAIC's objection lacked merit.
MVAIC v Astro Med. Care P.C. (2009 NY Slip Op 50509(U)) Supreme Court, Queens County, March 26, 2009Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld the arbitrator wrongly treated the coverage defense as precluded by the 30-day rule and, because the claimant knew the adverse vehicle's owner and insurer, remanded for MVAIC to prove other available insurance.
Kipor Medicine P.C. v MVAIC (2009 NY Slip Op 29085) Civil Court of the City of New York, Kings County, February 23, 2009MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this pointHeld that non-qualified-person status is a coverage defense on which MVAIC bears the burden, and since MVAIC offered no evidence that the assignor was not a qualified person, the provider was awarded judgment.
Akita Med. Acupuncture, P.C. v Motor Veh. Acc. Indem. Corp. (2007 NY Slip Op 50898(U)) District Court of Nassau County, First District, May 1, 2007Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC's claims examiner established no notice of intention was filed within 180 days, the provider offered only counsel's affirmation, and no equitable estoppel was shown; MVAIC's lack-of-coverage defense survived its failure to deny.
Maple Med. Acupuncture, P.C. v Motor Veh. Acc. Indem. Corp. (2007 NY Slip Op 50827(U)) Nassau District Court, April 20, 2007Eligibility cannot be decided on this record: triable issue, or defense preserved and remitted/remandedHeld MVAIC's lack-of-coverage defense not waived by its improper denial but its burden to prove; its inadmissible, hearsay investigator proof did not conclusively show a late police report and raised credibility questions requiring a hearing.
Akita Med. Acupuncture, P.C. v Motor Veh. Acc. Indem. Corp. (2006 NY Slip Op 26503) District Court of Nassau County, First District, December 14, 2006Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the claimant was not a covered person because MVAIC showed it never received a notice of intention to claim or a police report, and the provider showed no compliance. MVAIC's untimely denial did not preclude this lack-of-coverage defense.
Universal Acupuncture Pain Servs. P.C. v MVAIC (2006 NY Slip Op 52343(U)) District Court of Nassau County, First District, December 5, 2006Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the provider failed to carry its burden of showing the condition precedent of covered-person status, since the assignor never supplied proof of residency on the notice of intention, so MVAIC's untimely denial did not prevent dismissal.
Akita Med. Acupuncture P.C. v MVAIC (2006 NY Slip Op 52340(U)) District Court of Nassau County, First District, December 5, 2006Eligibility is treated as the claimant's burden / condition precedent and the claimant did not prove it; claim fails or is prematureHeld the claimant was not a qualified person because no police report or other proof that the accident was reported within 24 hours was given to MVAIC, and MVAIC's untimely denial did not preclude this coverage defense.
Bonsai Med. Acupuncture, P.C. v Motor Veh. Acc. Indem. Corp. (2006 NY Slip Op 51583(U)) Nassau District Court, August 14, 2006Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that groundHeld the assignor was not a covered person because MVAIC's claims representative showed no notice of intention to make claim was filed within 180 days, the provider did not address it, and MVAIC's untimely denial did not preclude the defense.
Olmecs Med. Supplies, Inc. v Motor Veh. Acc. Indem. Corp. (2006 NY Slip Op 50836(U)) Suffolk District Court, May 9, 2006MVAIC may not rely on the eligibility objection because of untimely denial/verification or waiverHeld MVAIC could not obtain dismissal on the ground that the assignor had not qualified, because the 30-day pay-or-deny period ran from receipt of the claim regardless of qualification and MVAIC neither paid, denied nor timely sought verification.
Pomerico v Elrac Inc. (2004 NY Slip Op 50006(U)) Civil Court of the City of New York, Queens County, January 6, 2004Court finds the claimant qualified/covered, or the condition met or excused, on the claimant's own proofHeld the passengers were qualified persons because the tortfeasor's insurer's later insolvency equalled a disclaimer of coverage, and compelled MVAIC to accept their notices filed two months late since it showed no prejudice.

How this page is made: the decisions are those in our case-law database that cite this question's leading cases or were tagged with its subject. A language model read each one in full and recorded whether it rules on the question, the position it took and a one-sentence summary; a second, independent reading checked every entry. Court, department, date and the citation links come from the database. Read the decision before relying on it.