Key Takeaway
New York courts require insurance companies to prove they never received verification documents with specific evidence and personal knowledge, not mere assertions.
Proving Non-Receipt of Verification Documents in No-Fault Insurance Cases
New York’s no-fault insurance system requires healthcare providers to submit verification documents when requested by insurance companies. However, insurers often claim they never received these materials as grounds for denying claims. The burden of proof lies with the insurance company to demonstrate actual non-receipt, and courts have established strict standards for what constitutes adequate evidence.
This issue frequently arises in New York No-Fault Insurance Law disputes, where insurance companies attempt to avoid payment by asserting that requested verification was never provided. The Eagle Surgical Supply case demonstrates how courts scrutinize these claims and the specific evidence required to support them.
Jason Tenenbaum’s Analysis:
Eagle Surgical Supply, Inc. v Travelers Indem. Co., 2010 NY Slip Op 51456(U)(App. Term 2d Dept. 2010)
“efendant failed to establish that plaintiff did not provide the requested verification. Defendant’s litigation examiner did not even allege that the requested verification was outstanding, and defendant’s attorney failed to demonstrate that she had personal knowledge to support her assertion of defendant’s non-receipt of such documents (see Warrington v Ryder Truck Rental, Inc., 35 AD3d 455, 456 ; Feratovic v Lun Wah, Inc., 284 AD2d 368, 368 ; V.S. Med. Servs., P.C. v New York Cent. Mut. Ins., 20 Misc 3d 134, 2008 NY Slip Op 51473 ). Accordingly, the order is reversed and defendant’s motion for summary judgment dismissing the complaint is denied.”
By the way: you saw this before- A.B. Medical Services, PLLC v. Country-Wide Ins. Co., 23 Misc.3d 140(A)(App. Term 2d Dept. 2009):
Since the affidavit of defendant’s no-fault litigation supervisor lacks specificity to support the assertion that defendant did not receive the verification it requested, it was insufficient to establish that the verification was still outstanding and, thus, defendant’s time to pay or deny the claims was not tolled.
Key Takeaway
Insurance companies cannot simply assert they never received verification documents. Courts require specific evidence and personal knowledge from witnesses who can testify about non-receipt. Vague or conclusory affidavits from litigation supervisors or attorneys without direct knowledge are insufficient to establish that additional verification non-receipt occurred, and such failures can result in denial of the insurer’s motion for summary judgment.
This precedent reinforces the importance of proper documentation and evidence standards in verification compliance disputes, ensuring that healthcare providers receive fair treatment in no-fault insurance claims processing.
Legal Update (February 2026): Since this 2010 post, New York’s no-fault insurance regulations have undergone multiple revisions, including amendments to verification request procedures, electronic submission requirements, and documentation standards under 11 NYCRR Part 65. Additionally, recent court decisions may have refined the evidentiary standards for proving non-receipt of verification documents. Practitioners should verify current regulatory provisions and recent case law developments when handling verification disputes.
