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.
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.
