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Ever since the seminal decisions by the New York Court of Appeals in 1997 in Presbyterian Hospital in the City of New York v. Maryland Casualty Company1 and Central General Hospital v. Chubb Group of Insurance Companies,2 the contours of no-fault law have been relatively clear: With the “exceptional exception”3 of a narrow category of defenses classified as “lack of coverage defenses,” all other potential defenses to a no-fault claim, including that of lack of medical necessity, had to be asserted by a no-fault insurer in a timely denial of claim, to wit, within 30 days after the insurer’s receipt of the bill.4 Should the insurer fail to pay or deny the claim within 30 days or send a timely request for verification, it would be precluded from defending the claim.

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