Key Takeaway
New York courts require insurance companies to prove they never received verification documents with specific evidence and personal knowledge, not mere assertions.
This article is part of our ongoing additional verification coverage, with 92 published articles analyzing additional verification issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
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.
Related Articles
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Additional Verification in No-Fault Claims
Under New York's no-fault regulations, insurers may request additional verification of a claim within specified time limits. The timeliness, scope, and reasonableness of verification requests — and the consequences of a claimant's failure to respond — are among the most litigated issues in no-fault practice. These articles examine the regulatory framework for verification requests, court decisions on compliance, and the interplay between verification delays and claim determination deadlines.
92 published articles in Additional Verification
Keep Reading
More Additional Verification Analysis
No Denial Required When Provider Fails to Respond to Verification Within 120 Days
Appellate Division holds insurers need not issue a denial when a medical provider or injured person fails to respond to verification demands within 120 days. Analysis of Chapa...
Feb 25, 2026120-day rule and Fee Schedule
New York court ruling demonstrates how healthcare providers can lose no-fault claims due to verification failures and fee schedule violations in insurance disputes.
Feb 1, 2020An unobjected to EUO notice precludes a later challenge to the propriety of the notice
New York no-fault insurance law case establishing that failure to object to EUO notice prevents later challenges to its validity or reasonableness.
May 31, 2010No need to send letter to attorney
Court clarifies delay letter requirements under 11 NYCRR 65-3.6(b), ruling insurers only must notify attorneys when seeking verification from third parties, not plaintiffs.
Jan 19, 2018A verification non receipt decision that does not make sense.
Court decision analysis reveals flawed verification non-receipt ruling where affidavit failed to specify mailed items or dates, creating questionable precedent.
Nov 17, 2015Additional Verification non-receipt and lack of medical necessity.
Court ruling on no-fault insurance claim denial for acupuncture services due to insufficient response to verification requests and lack of medical necessity evidence.
Apr 26, 2013Common Questions
Frequently Asked Questions
What is additional verification in no-fault insurance?
Additional verification is a request by the insurer for more information to process a no-fault claim, authorized under 11 NYCRR §65-3.5. When the insurer sends a verification request, the 30-day clock for claim processing is tolled (paused) until the requested information is received. This is a common insurer tactic to delay payment — but the verification request must be timely and relevant to be valid.
How long does an insurer have to request additional verification?
Under the no-fault regulations, the insurer must request initial verification within 15 business days of receiving the claim. Follow-up verification requests must be made within 10 business days of receiving a response to the prior request. If the insurer fails to meet these deadlines, the verification request is invalid and cannot be used to toll the claim processing period.
What types of additional verification can a no-fault insurer request?
Under 11 NYCRR §65-3.5, insurers may request medical records, provider licensing documentation, proof of treatment rendered, tax returns or financial records (in certain fraud investigations), authorization for release of medical records, and signed NF-3 verification forms. The verification request must be relevant to the claim and not overly burdensome. Requests for information not reasonably related to claim processing may be challenged as improper.
What happens if I don't respond to a no-fault verification request?
Failure to respond to a timely and proper verification request can result in denial of your no-fault claim. Under 11 NYCRR §65-3.5(o), if the requested verification is not provided within 120 calendar days of the initial request, the claim is deemed denied. The 120-day period runs from the date of the original request. However, if the verification request itself was untimely or improper, the denial based on non-response may be challenged.
Was this article helpful?
About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a additional verification matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.