It has been argued by some that over the past three to four years, the Appellate Term, Second Department has issued decisions that can fairly be described as favorable to the New York no-fault insurer when compared to those stemming from the Appellate Term, First Department. This new trend in the jurisprudence of the Appellate Term, Second Department is best exemplified by sixteen no-fault cases that were decided by the latter court on Oct. 1, 2010. Fifteen of these cases were decided in favor of the no-fault insurer. It should be noted that the decision making of the Appellate Term, Second Department over the past few years stands in marked contrast to that of the Appellate Term, First Department, dealing with similar issues.1
However, a review of the cases decided by the Appellate Term, Second Department in the last three to four years review reveals a rather interesting phenomenon. The same three issues repeatedly and consistently keep on coming up for review and constitute a disproportionately large percentage of the no-fault cases on the Appellate Term, Second Department’s docket. These issues may be identified as follows: (1) whether a medical provider can establish a prima facie case through a third-party biller; (2) the appropriate fee that a licensed acupuncturist is entitled to receive and (3) the no-fault insurer’s proof of timely mailing of denials of claim and verification requests.
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