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How did you know that you never received the requested verification?
Additional Verification

How did you know that you never received the requested verification?

By Jason Tenenbaum 8 min read

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.

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

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More Additional Verification Analysis

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No Denial Required When Provider Fails to Respond to Verification Within 120 Days

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New York court ruling demonstrates how healthcare providers can lose no-fault claims due to verification failures and fee schedule violations in insurance disputes.

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An 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.

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No 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.

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A 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, 2015
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Additional 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.

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View all Additional Verification articles

Common 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.

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Attorney Jason Tenenbaum

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.

24+ years in practice 1,000+ appeals written 100K+ no-fault cases $100M+ recovered

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.

Jason Tenenbaum, Personal Injury Attorney serving Long Island, Nassau County and Suffolk County

About the Author

Jason Tenenbaum

Jason Tenenbaum is a personal injury attorney serving Long Island, Nassau & Suffolk Counties, and New York City. Admitted to practice in NY, NJ, FL, TX, GA, MI, and Federal courts, Jason is one of the few attorneys who writes his own appeals and tries his own cases. Since 2002, he has authored over 2,353 articles on no-fault insurance law, personal injury, and employment law — a resource other attorneys rely on to stay current on New York appellate decisions.

Education
Syracuse University College of Law
Experience
24+ Years
Articles
2,353+ Published
Licensed In
7 States + Federal

Discussion

Comments (11)

Archived from the original blog discussion.

S
SunTzu
An employee with foundation should set forth the procedures utilized to ensure the proper receipt and routing of incoming mail and that said procedures were complied with in the instant case? This would seem a logical corollary to the manner in which outgoing mail is typically established as mailed. Damned if I have seen this case, however.
DM
David M. Gottlieb
What was with Golia’s pat on the head at the end?
S
SunTzu
I was rather surprised at Golia’s concurrence because it can be read in a manner that could help the medical provider– i.e. lack of receipt not proven up by “personal knowledge.” Would have been more accurate to state “via personal knowledge” or otherwise. Of course, proving lack of receipt of a document sent to a corporation solely via personal knowledge would probably be impossible, assuming the affiant is not lying. I don’t think the court’s have really worked out the lack of receipt angle, and this is part of the fallout.
J
JT Author
It could help the medical providers. I agree, and that is fine in my opinion. Why some defendants do not put the same proof in support of their verification non receipt motions, viz, the actual non-receipt of the verification, as would be put in the non-receipt of bills motion, viz, the actual non-receipt of the bills, has always surprised me. Golia is just commenting on some of the shoddy practices that are out there. That being said, we are all guilty of making mistakes, including you and I, Sun; so those who live in glass houses should not throw stones.
S
SunTzu
Sorry but I do not make legal error as proficiently as that particular justice, and when I do, it isn’t the law. When divergent rules of evidence apply to medical providers as compared to insurers, for example, that’s the time to exercise the right to free speech, not the time to be concerned over casting stones.
J
JT Author
There is nothing wrong with exercising your First Amendment rights. I even let Zuppa do it here, usually much to my chagrin. Much of what comes out of the Appellate Term are tiny nuances that represent issues of first impression. While I understand much of the providers’ consternation over certain legal precedent that has come from that court, I do not think it is necessarily fair to make such broad based statements regarding certain justices. I guarantee I could find quite a few cases where “that particular justice” ruled against an insurance carrier, where such a ruling could be demonstrated to be unfounded. I am not casting stones – just speaking the truth.
S
SunTzu
I have no plans to use your site as a bully pulpit of that sort. Indeed, I was somewhat nice to him in the above post. And I pick my battles more carefully than you suggest.
J
JT Author
I am aware of that. I am not suggesting anything.
RZ
Raymond Zuppa
You speak the truth J.T. You can’t handle the truth.
S
SunTzu
Generally speaking, the same things piss us all off, the Zuppa included. It’s all about the consistent application of the law. When we are told that everything we learned in law school is wrong, we reject it and fight.
RZ
Raymond Zuppa
Now that deserves a bravo. From the goddam moment I got a handle on hearsay to my Appellate Advocacy coach saying “do not give a string cite — proof the main case by showing its factually on all fours with this case.” To this whole damn pitiful tactic of misstating my case and then arguing against the misstated case — primarily practiced by defense counsel obviously too stupid to be addressing my real argument. I took law school and the law very seriously and I am finding that the Courts do what they want based upon bias not the law. Moreover the courts buy into the stupid tactics if said tactics emanate from the side or counsel that holds the courts’ sympathy. Say goodbye to one of the checks and balances that is supposed to maintain our democracy and hello to the neo corporate/government fascism of the this brave new world in Amerika. Why did I waste my time. I could be making real money doing something else.

Legal Resources

Understanding New York Additional Verification Law

New York has a unique legal landscape that affects how additional verification cases are litigated and resolved. The state's court system includes the Civil Court (for claims up to $25,000), the Supreme Court (the primary trial court for unlimited jurisdiction), the Appellate Term (which hears appeals from lower courts), the Appellate Division (divided into four Departments, with the Second Department covering Long Island, Brooklyn, Queens, Staten Island, and several upstate counties), and the Court of Appeals (the state's highest court). Each court has its own procedural requirements, local rules, and case-assignment practices that can significantly impact the outcome of your case.

For additional verification matters on Long Island, cases are typically filed in Nassau County Supreme Court (at the courthouse in Mineola) or Suffolk County Supreme Court (in Riverhead). No-fault arbitrations are heard through the American Arbitration Association, which assigns arbitrators throughout the metropolitan area. Workers' compensation claims go to the Workers' Compensation Board, with hearings at district offices across the state. Understanding which forum is appropriate for your case — and the specific procedural rules that apply — is essential for a successful outcome.

The procedural landscape in New York also includes important timing requirements that can affect your case. Most civil actions are subject to statutes of limitations ranging from one year (for intentional torts and claims against municipalities) to six years (for contract actions). Personal injury cases generally have a three-year deadline under CPLR 214(5), while medical malpractice claims must be filed within two and a half years under CPLR 214-a. No-fault insurance claims have their own regulatory deadlines, including 30-day filing requirements for applications and 45-day deadlines for provider claims. Understanding and complying with these deadlines is critical — missing a filing deadline can permanently bar your claim, regardless of how strong your case may be on the merits.

Attorney Jason Tenenbaum regularly practices in all of these venues. His office at 326 Walt Whitman Road, Suite C, Huntington Station, NY 11746, is centrally located on Long Island, providing convenient access to courts and offices throughout Nassau County, Suffolk County, and New York City. Whether you need representation in a no-fault arbitration, a personal injury trial, an employment discrimination hearing, or an appeal to the Appellate Division, the Law Office of Jason Tenenbaum, P.C. brings $24+ years of real courtroom experience to your case. If you have questions about the legal issues discussed in this article, call (516) 750-0595 for a free, no-obligation consultation.

New York's substantive law also presents distinct challenges. In motor vehicle cases, the no-fault system under Insurance Law Article 51 provides first-party benefits regardless of fault, but limits the right to sue for non-economic damages unless the plaintiff establishes a "serious injury" under one of nine statutory categories. This threshold — codified at Insurance Law Section 5102(d) — requires medical evidence showing more than a minor or subjective injury, and courts have developed detailed standards for each category. Fractures must be documented through imaging studies. Claims of permanent consequential limitation or significant limitation of use require quantified range-of-motion testing with comparison to norms. The 90/180-day category demands proof that the plaintiff was unable to perform substantially all of their usual daily activities for at least 90 of the 180 days following the accident.

In employment discrimination cases, the legal standards vary depending on whether the claim arises under state or local law. The New York State Human Rights Law employs a burden-shifting framework: the plaintiff must first establish a prima facie case by showing membership in a protected class, qualification for the position, an adverse employment action, and circumstances giving rise to an inference of discrimination. The burden then shifts to the employer to articulate a legitimate, non-discriminatory reason for its decision. If the employer meets this burden, the plaintiff must demonstrate that the stated reason is pretextual. The New York City Human Rights Law, by contrast, applies a broader standard, asking whether the plaintiff was treated less well than other employees because of a protected characteristic.

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