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The failure to respond to ALL of the requested verification renders lawsuit premature
Additional Verification

The failure to respond to ALL of the requested verification renders lawsuit premature

By Jason Tenenbaum 8 min read

Key Takeaway

New York court rules that partial compliance with additional verification requests renders no-fault insurance lawsuits premature, requiring complete response to all items.

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.

Understanding Additional Verification Requirements in No-Fault Insurance Claims

In New York’s no-fault insurance system, insurance companies have the right to request additional verification when reviewing claims for medical services or benefits. This process allows insurers to gather necessary documentation to properly evaluate claims before making payment decisions. However, healthcare providers and other claimants must understand that partial compliance with these verification requests can have serious consequences for their ability to pursue legal action.

The verification process serves as a critical checkpoint in New York No-Fault Insurance Law. When an insurer requests additional documentation, the claimant must provide a complete response to maintain their right to file a lawsuit for unpaid benefits. This requirement ensures that insurance companies have all necessary information to make informed coverage decisions while protecting claimants who fully comply with verification requests.

Understanding what constitutes adequate compliance with verification requests is essential for healthcare providers and other parties seeking no-fault benefits. Additional verification non-receipt issues frequently arise in litigation, making it crucial to know the standards courts apply when evaluating compliance.

Jason Tenenbaum’s Analysis:

Eagle Surgical Supply, Inc. v Travelers Indem. Co., 2010 NY Slip Op 51775(U)(App. Term 2d Dept. 2010)

“In opposition to the motion, plaintiff argued, among other things, that it had responded to the requests for additional verification, and annexed its responses as an exhibit.”

“he record unequivocally demonstrates that plaintiff failed to provide all of the requested additional verification. As a result, the order granting defendant’s motion for summary judgment dismissing the complaint is affirmed”

So, if you ask for 10 things and only get 9, then the action is still premature. This case is interesting for many reasons.

Key Takeaway

This decision establishes that complete compliance with verification requests is mandatory in no-fault insurance cases. Even if a claimant responds to most requested items, failing to provide any single piece of requested verification renders a lawsuit premature. Healthcare providers must carefully review all verification requests and ensure they address every item to preserve their right to litigation. More verification non receipt issues continue to impact cases throughout New York’s court system.


Legal Update (February 2026): The standards and procedures governing additional verification requirements in New York no-fault insurance claims may have evolved since this 2010 analysis through regulatory amendments, updated Department of Financial Services guidance, or court decisions refining compliance standards. Practitioners should verify current verification requirements, acceptable response formats, and timing provisions under the most recent regulations and case law.

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

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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, 2026
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120-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, 2020
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Additional Verification – proper response

Court ruling shows healthcare providers must specifically address verification requests rather than making general statements about not possessing records.

Apr 6, 2017
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Non receipt and verification

Court ruling on non-receipt denials and verification requirements in NY no-fault insurance claims, including burden of proof standards for medical providers.

Apr 7, 2015
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Lack of causation proven prima facie through a biomechanical study

Court grants summary judgment based on biomechanical engineer's conclusion that claimed injuries could not have resulted from the accident, shifting burden to plaintiff.

Mar 2, 2012
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Appellate Division to Rule on Timeliness of Follow-Up Additional Verification Requests

Appellate Division to rule on premature additional verification requests in NY no-fault insurance. Analysis of Infinity Health Products case for Long Island attorneys.

Aug 19, 2009
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 (7)

Archived from the original blog discussion.

S
SunTzu
This case does not pertain to invalid demands or correspondence informing that certain verification cannot be obtained. The plaintiff did not argue those points in the appellate brief, which I obtained. Plaintiff’s counsel merely argued that the evidence established all the verification demands were complied with. No discussion was made of any particular demand. Argument section of brief was three pages.
J
JT Author
Slick – what makes you think some of us do not represent homeowners averting foreclosure and debtors who owe credit card debts?
S
slick
jt, I havent seen it, but of course it could be out there. it’s not meant to be an attack on the defense bar. all i’m saying is there’s a large overlap in skills for any individuals or firms that are interested. I actually think the money might be better as well.
RZ
raymond zuppa
Shame on you Slick. No Fault Defense attorneys are just as big bottom feeders as No Fault Plaintiff attorneys. They’ll represent an old lady who is being foreclosed upon just as long as the check clears. During rough times you can find them in traffic court offering to rep people who get speeding tickets. A pervert with a bank account — a no fault defense attorney will take the case. No Fault defense attorneys are just as noble as all the rest of us.
J
JT Author
We all do what we have to in order to survive, and many of us either volunteer or perform services at a highly reduced rate to help those in need. Some of us take pride in fighting a certain foreclosure firm based in Buffalo, a few credit-card collection firms based in Nassau and Western Suffolk, contractors who are getting sued because a Claimant wants her driveway paved and remodeled for free, etc. I also prosecuted a Family Court case at a highly reduced rate because the child’s father, who had a nice state pension, was trying to deny his child a college education, despite a divorce judgment that said otherwise, and a mother who had little to no money. Perhaps I am a little sensitive to some of the accusations that people make about no-fault defense attorneys.
S
slick
like i said, it’s nothing personal, but I am confident that you and a lot of other defense guys could contest a bank’s prima facie case in your sleep. Gov. Patterson even signed an attorneys’ fees statute for the attorneys who represent homeowners against foreclosure so it might even be a good business. I dont think it would be something you would take for free or at a highly reduced rate. I think there’s money in it. It’s just a matter of marketing to get the clients.
RZ
raymond zuppa
That’s a low blow J.T. We had a gentleman’s agreement that you would never discuss the case wherein you represented my ex wife. And I deny everything you said. My pension is okay and the little brat might not be my son despite the so called “overwhelming DNA evidence” you presented. My cases against certain insurance entities are all pro bono and in fact have cost me thousands of dollars. I also cleared a man of a homicide 52 years after the fact — pro bono — because I loved the client and wanted to do something no one ever did. It’s all about the hate and conflict. I really love it.

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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