Key Takeaway
Court rules that generic affidavit from third-party biller insufficient to prove mailing compliance in no-fault verification dispute case.
Evidence Standards in No-Fault Verification Compliance Cases
No-fault insurance verification disputes often hinge on whether parties can prove they properly mailed required documents. In these cases, courts scrutinize the quality of evidence presented, particularly when medical providers attempt to prove compliance with additional verification requests. The Pomona Medical Diagnostic case demonstrates how courts apply strict evidentiary standards when evaluating proof of mailing compliance.
This decision highlights an important parallel between verification mailing cases and MVAIC Independent Medical Examination (IME) no-show cases, where similar evidentiary principles apply. The court’s analysis underscores that generic testimony about office procedures without specific knowledge of the mailing at issue fails to meet the burden of proof required in New York no-fault insurance law.
Jason Tenenbaum’s Analysis:
Pomona Med. Diagnostic P.C. v Praetorian Ins. Co., 2013 NY Slip Op 51798(U)(App. Term 1st Dept. 2013)
“The affidavit of an employee of a third-party biller, who had no personal knowledge of the date the purported “verification compliance” letter was mailed to defendant, and described in only the most general terms her office’s mailing practices and procedures, was insufficient to raise an issue of fact. Westchester Med. Ctr. v Countrywide Ins. Co., 45 AD3d 676, 677 )”
What is noteworthy here is that the same discussion that the Court gives to the MVAIC IME no-show mailing cases is given here to Pomona.
Key Takeaway
Courts require specific, personal knowledge of mailing practices rather than generic testimony. Third-party billers cannot rely solely on general office procedures to prove compliance with verification requests. The evidence must demonstrate actual knowledge of the specific mailing date and circumstances to create a genuine issue of fact in litigation.
Legal Update (February 2026): Since this 2013 decision, New York’s no-fault verification procedures and evidentiary standards may have been modified through regulatory amendments or updated Insurance Department guidelines. Practitioners should verify current provisions regarding proof of mailing requirements, acceptable forms of evidence for verification compliance, and any procedural changes that may affect burden of proof standards in additional verification disputes.
