Key Takeaway
New York court ruling highlights why insurance companies can't rely on employee testimony about mailing practices that occurred before their employment began.
Understanding Employee Testimony Limitations in Insurance Mailing Cases
In New York no-fault insurance litigation, establishing proper mailing of claim denials is crucial for insurance companies defending their cases. A fascinating aspect of this requirement emerges when insurance companies try to use employee testimony to prove their mailing practices — but what happens when the employee wasn’t even working there when the alleged mailing occurred?
This scenario plays out regularly in no-fault practice, where insurance companies must demonstrate not only that they actually mailed denial forms, but also that they followed proper office procedures during the relevant time period. The timing of employee knowledge becomes critical, as mailing disputes often hinge on establishing consistent office practices rather than just individual instances.
Jason Tenenbaum’s Analysis:
South Nassau Orthopedic Surgery v Auto One Ins. Co., 2011 NY Slip Op 51300(U)(App. Term 2d Dept. 2011)
Where have we seen this before?
“Defendant did not raise a triable issue of fact in opposition to plaintiff’s motion or establish its entitlement to summary judgment on its cross motion. In her affidavit, defendant’s litigation manager stated that she had begun working for defendant after the claim denial forms at issue had allegedly been mailed by defendant. As defendant did not establish actual mailing of [*2]the claim denial forms or defendant’s standard office practice and procedure for the mailing of the claim denial forms during the pertinent time period, defendant failed to show that its claim denial forms were timely mailed”
Oh by the way, I am sure Plaintiff received the denial. Yet, the difference between fact and fiction can sometimes be indistinguishable in this practice.
Key Takeaway
Insurance companies cannot rely on employee affidavits to establish mailing practices if the employee started working after the relevant mailing occurred. Courts require testimony from someone with actual knowledge of the office procedures during the pertinent time period, making employee tenure a critical factor in certified mail and regular mail disputes.
