Key Takeaway
New York court rules that simply claiming you never received a verification request isn't enough to defeat summary judgment in no-fault insurance cases.
Understanding Verification Requirements in New York No-Fault Cases
In New York’s no-fault insurance system, medical providers must respond to insurance companies’ requests for additional verification of their claims. When providers fail to respond to these requests, insurers can seek summary judgment to dismiss claims as premature. However, providers sometimes argue they never received the verification requests in the first place.
The Appellate Term’s decision in Darlington Med. Diagnostics demonstrates why courts require more than just a bare assertion of non-receipt to create a genuine dispute of fact. This ruling reinforces the high standard providers must meet when claiming they never received additional verification requests from insurers.
Jason Tenenbaum’s Analysis:
Darlington Med. Diagnostics, P.C. v Praetorian Ins. Co., 2011 NY Slip Op 51634(U)(App. Term 1st Dept. 2011)
It being undisputed on the record that plaintiff failed to respond to defendant’s verification requests, defendant established its prima facie entitlement to summary judgment dismissing the claim as premature (see St. Vincent Med. Care, P.C. v Country Wide Ins. Co., 80 AD3d 599, 600 ).
In opposition, plaintiff’s conclusory denial of receipt of the initial verification letter was insufficient to raise a triable issue (see Nassau Ins. Co. v Murray, 46 NY2d at 829-830; Pardo v Central Coop. Ins. Co., 223 AD2d 832, 833 ; Abuhamra v New York Mut. Underwriters, 170 AD2d 1003, 1004 ).
Key Takeaway
Medical providers cannot defeat summary judgment simply by claiming they never received verification requests. Courts require substantive evidence beyond conclusory denials of receipt. This standard protects the integrity of New York’s no-fault insurance system by ensuring providers cannot avoid their verification obligations through unsupported claims of non-receipt.
Legal Update (February 2026): Since this 2011 decision, New York’s no-fault regulations have undergone several amendments, including updates to verification request procedures and electronic communication requirements under 11 NYCRR Part 65. Additionally, appellate courts have continued to refine the evidentiary standards for establishing non-receipt of verification requests. Practitioners should verify current regulatory provisions and recent case law interpreting verification response requirements.
