Key Takeaway
NY no-fault insurance verification requests don't require EIP notification when seeking info from medical providers, per Triangle R v Clarendon case analysis.
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.
Triangle R, Inc. v Clarendon Ins. Co., 2010 NY Slip Op 52159(U)(App. Term 2d Dept. 2010)
In a case that appears to go against the grain of 65-3.6(b), the Appellate Term observed, and I suspect properly (but see my thoughts below) the following:
“Contrary to plaintiff’s contention, the fact that copies of the verification requests, which were sent to plaintiff’s assignor, were sent to the wrong address does not render the verification requests a nullity since the requested verification was sought from plaintiff (see Insurance Department Regulations § 65-3.5 ; § 65-3.6 ”
65-3.6(b) says the following: “Verification requests. At a minimum, if any requested verifications has not been supplied to the insurer 30 calendar days after the original request, the insurer shall, within 10 calendar days, follow up with the party from whom the verification was requested, either by telephone call, properly documented in the file, or by mail. At the same time the insurer shall inform the applicant and such person’s attorney of the reason(s) why the claim is delayed by identifying in writing the missing verification and the party from whom it was requested.”
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The above being said, there is no reason in an assigned claim why the assignor or his attorney needs to be on notice of any outstanding verification requests seeking information from someone other than the assignor. The provider, through accepting an assignment, has relinquished its right to hold the assignor responsible for the cost of the medical services unless the assignor himself breaches a policy condition.
In the situation where an assignor does not treat on an assignment or treats through an authorization, the logic of this case would be wanting, however, since the injured person would be liable to the provider for the services for which no-fault would not reimburse him. In essence, the injured person, in this paradigm, would need to demonstrate the provider’s compliance with the verification request or a reason for the invalidity of the verification request, in order to prevail in a direct first-party action or arbitration against the provider.
Related Articles
- Understanding Verification Requests in New York No-Fault Insurance Claims
- The Verification Process in No-Fault Insurance: When Technical Requirements Override Common Sense
- The 120-day rule
- Procedural Fairness in No-Fault Insurance Litigation: Is It Fair?
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2010 post, New York Insurance Department Regulations Part 65 have undergone multiple amendments, particularly regarding verification request procedures and notification requirements. Practitioners should verify current provisions of sections 65-3.5 and 65-3.6, as the timing requirements, notification protocols, and documentation standards discussed may have been modified through subsequent regulatory updates.
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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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.
