Why Trust This 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.
MRI Verification Requirements: When Carriers Deny Claims for Missing Films
In New York no-fault insurance disputes, medical providers frequently face claim denials based on alleged failure to provide requested verification materials. This issue becomes particularly complex when dealing with MRI facilities and the submission of actual film images. The Radiology Today case provides important guidance on how courts evaluate these disputes and what evidence carriers must present to support their denial decisions.
Understanding the verification process is crucial for both providers and carriers operating under New York No-Fault Insurance Law. When carriers request additional verification, they must demonstrate they properly made these requests and that providers failed to respond appropriately. The burden of proof requirements for such denials have been addressed in various contexts, as seen in cases involving additional verification non-receipt.
Jason Tenenbaum’s Analysis:
Radiology Today, P.C. v New York Cent. Mut. Fire Ins. Co., 2011 NY Slip Op 52452(U)(App. Term 2d Dept. 2011)
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The carrier is delaying for an MRI film from an MRI facility. What is the basis? Lack of causal relationship? Seeking to obtain the film at the workers compensation rate of $5.00 per sheet, as opposed to having to pay market rate during discovery in the personal injury matter?
Here are the facts and the holding.
“Contrary to plaintiff’s contention, the affidavit of defendant’s litigation examiner, submitted in support of defendant’s motion, established that defendant had timely mailed its requests and follow-up requests for verification (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 ), and that plaintiff had failed to provide the MRI films which, among other things, defendant’s requests for verification had sought.”
Key Takeaway
This decision reinforces that insurance carriers must provide proper documentation, typically through affidavits from litigation examiners, to prove they timely requested verification materials and that providers failed to respond. Courts will examine the evidence carefully to determine whether carriers met their burden of proof before denying claims based on verification non-receipt issues.
Legal Update (February 2026): Since this post’s publication in 2012, New York’s no-fault fee schedules and verification procedures have undergone multiple regulatory amendments. Practitioners should verify current provisions regarding MRI reimbursement rates, verification request protocols, and time limits for additional documentation requests, as these requirements may have been substantially modified through recent Insurance Department regulations.
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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
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.
Feb 25, 2026
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
A verification non receipt decision that does not make sense.
Court decision analysis reveals flawed verification non-receipt ruling where affidavit failed to specify mailed items or dates, creating questionable precedent.
Nov 17, 2015
Additional Verification non-receipt and lack of medical necessity.
Court ruling on no-fault insurance claim denial for acupuncture services due to insufficient response to verification requests and lack of medical necessity evidence.
Apr 26, 2013
The destruction of peer hearsay: It is not hearsay – and much more
Examining peer hearsay exceptions in NY no-fault cases, medical record admissibility, and verification procedures in Urban Radiology v Tri-State Consumer.
Jun 10, 2010
There is no safety valve for a late follow-up
Court ruling establishes that late follow-up EUO scheduling letters void claim denials, creating split with other decisions on no-fault insurance timing requirements.
Jan 19, 2018Was this article helpful?
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.
