Additional Verification

A letter saying that a no-fault claim is delayed is not necessarily a request for verification. In Leica Supply, the insurer’s letters requested no specific information, so they did not extend its time to pay or deny the claims.

Historical note: Leica Supply v GEICO decided the effect of these delay letters, not a universal checklist for every document or examination request. The current verification hub separates that issue from the later 120-day response provisions and the 2026 Chapa ruling.

Last reviewed: September 2026.

The letters were the issue on appeal

Leica Supply, Inc. v GEICO Indemnity Co., 39 Misc 3d 132(A), decided March 29, 2013, followed a nonjury trial. The Civil Court had dismissed the medical supplier’s complaint. On appeal, the parties’ dispute was limited to whether the insurer’s letters tolled the statutory payment period.

The Appellate Term for the Second, Eleventh and Thirteenth Judicial Districts found that the letters merely notified the supplier of a delay. They did not ask for specific verification. Without that toll, the insurer was precluded from relying on its lack-of-medical-necessity defense. The court reversed and remitted the matter for entry of judgment for the supplier, with the statutory interest and attorney’s-fee calculation.

That is a particular procedural result. The decision does not create an automatic approval system for every claim accompanied by an inadequate letter. The provider’s proof, the defense asserted and the issues preserved for decision still matter.

Jason’s question about specificity

The original commentary below asks whether the letters concerned an IME, an EUO, police records or DWI information. Those are Jason’s examples and questions. The published opinion does not identify any of them as the information sought in Leica.

The useful distinction is between a reason for delay and an identifiable request. A recipient can read “we are waiting for information” without knowing what it is supposed to supply. A court deciding tolling has to be able to connect the correspondence to the verification actually sought.

For a claim file, compare the initial letter with any separate request it references. Keep those documents together. A generic status notice and a separate, properly supported request should not be evaluated as though only the status notice exists. Leica’s short opinion does not supply the underlying letters or decide every possible combination of correspondence.

What the follow-up rule asks the insurer to identify

DFS Regulation 68, § 65-3.6(b), addresses verification that remains outstanding 30 calendar days after the original request. It calls for follow-up within the next ten calendar days, by mail or a telephone call properly documented in the file. The insurer must also inform the applicant and the applicant’s attorney, in writing, of the missing verification and the party from whom it was requested.

That wording makes the contents of the correspondence worth examining. The name of a letter template does not establish compliance. Nor does a claims-system entry that merely says “verification pending” identify which documents have not arrived.

The Triangle R timing note concerns a different dispute: follow-up requests that were sent, with their timing challenged. Leica concerns letters that failed to request specific verification in the first place.

A response dispute comes next

Once the request is identified, ask what was returned. In the hospital NF-5 decision, the hospital supplied the particular form version the insurer had requested. The insurer could not sustain its position that the response was inadequate merely by calling that requested version outdated.

In New Horizon Surgical, the record instead showed only a partial response. The court treated the outstanding verification as a basis for premature dismissal. These cases answer different questions: what was requested, whether the answer matched it, and whether relevant items remained missing.

For the reader comparing decisions, those distinctions are more useful than the single label “additional verification.” They also explain why a provider can prevail in one appeal while an insurer prevails in another.

Leica did not decide the 120-day rule

The 120-day document-verification provisions were added in 2013 and have their own applicability dates, warnings and response alternatives. They exclude prescribed NF forms, IMEs and EUOs. They should not be used to supply facts or deadlines missing from this older opinion.

The 2026 Chapa decision rejected an added 150-day cutoff for the denial at issue there. It did not turn every delay letter into a valid request.

Before using Leica in a current dispute, assemble the actual correspondence, evidence of sending and receipt, responses, and any denial. Identify the defense the insurer seeks to preserve. That record allows a meaningful comparison with the case; the unpaid bill or a “pending” status alone does not.

Jason’s original commentary

The contemporaneous comments below are preserved as historical commentary, with the case-specific and current-law qualifications explained above.

An interesting question involves how specific must delay letters be? I am assuming this was for an IME or EUO. Do the letters have to state the date of the examination? If it was for a police report or DWI information, must it state the precinct and the police department that is being sought? If DWI information, must it name the court and docket number?

Just wondering.

Connect to the Encyclopedia

Start with the no-fault verification hub and 2026 Chapa update for the governing framework and case directory. Related case notes:

• Triangle R: an unanswered request and a five-day-late follow-up.
• New Horizon: partial production and premature dismissal.
• Hospital NF-5: the insurer received the version it requested.
• NF-3 and Right Aid: the official provider form and receipt evidence.

For review of a particular no-fault verification dispute, request a Free Case Review. Keep the requests, responses and relevant claim dates available for that review.