I was employed with [BLANK] when the mailing activity occurred

Employment Timing Matters in Insurance Mailing Disputes

Insurance companies routinely face challenges when trying to prove they properly mailed denial letters and other critical documents to healthcare providers and patients. Courts require more than just an employee’s sworn statement — the witness must have personal knowledge of the company’s procedures during the specific time period in question.

This fundamental requirement of proof became the decisive factor in a 2010 New York case involving GEICO Insurance Company. The case illustrates a common but costly mistake that insurance companies make when defending mailing disputes: relying on employees who weren’t working for the company when the alleged mailing occurred.

The court’s decision emphasizes that insurance companies must establish two critical elements to prove proper mailing: actual evidence that the specific documents were mailed, and detailed testimony about the company’s standard office procedures from someone who was actually employed during the relevant period. Without both elements, even large insurance companies like GEICO can lose cases on procedural grounds alone.

This requirement for qualified witnesses extends beyond simple certified mail and regular mail scenarios and applies to all insurance correspondence disputes.

Jason Tenenbaum’s Analysis:

Friendly Physician, P.C. v GEICO Ins. Co., 2010 NY Slip Op 51770(U)(App. Term 2d Dept. 2010)

“Since the affidavit executed by defendant’s claim representative stated that she began working for defendant after the denial of claim forms at issue were allegedly mailed by defendant, and defendant did not otherwise establish the actual mailing of the denial of claim forms or its standard office practices and procedures for the mailing of denial of claim forms [*2]during the pertinent time period, defendant failed to establish that its denial of claim forms were timely mailed”

Key Takeaway

Insurance companies cannot rely on employees who started working after the relevant mailing date to testify about the company’s mailing procedures. The witness must have been employed during the actual time period when the disputed mailing allegedly occurred, and the company must provide specific evidence of both the mailing itself and the standard procedures in place at that time.