Key Takeaway
Court ruling on verification request mailing requirements in NY no-fault insurance claims, establishing that delivery to USPS completes the request process.
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.
Healing Health Prods., Inc. v New York Cent. Mut. Fire Ins. Co., 2014 NY Slip Op 24145 (App. Term 2d Dept. 2014)
In this case, a pro-forma non-receipt affidavit – similar to the one I suspect in E4 Servs., Inc. v Lincoln Gen. Ins. Co.
43 Misc.3d 136(A)(App. Term 1st Dept. 2014) – was sufficient to raise an issue of fact as to whether the verification was mailed. The Court opined on the significance of mailing the verification to the “attorney”
(1) “laintiff submitted an affidavit executed by its owner in which he described plaintiff’s practices and procedures that result in all mail being recorded in plaintiff’s computer system on the date of receipt, as well as being physically filed in the appropriate “patient” file. Plaintiff’s owner stated that he had reviewed the computer file and the physical file for the “patient” at issue, and that plaintiff has no record of having received verification requests for the claims at issue.”
(2) “For the purpose of determining whether a no-fault insurer’s time to pay or deny a claim has been tolled (see Insurance Department Regulations § 65-3.8 ), a request for written verification that the insurer communicates to the applicant by mail is complete upon its delivery to the United States Postal Service (cf. CPLR 2103 ). Thus, contrary to the finding of the Civil Court, the operative question in this case is not whether the requests were received by plaintiff, but whether defendant mailed them.”
(3) “Defendant correctly asserts that plaintiff did not make a prima facie showing that its attorney had not received the carbon copies of the verification requests that allegedly had been sent to counsel’s office. However, contrary to defendant’s argument, receipt of such letters did not give rise to a duty on the part of plaintiff’s counsel to forward these requests to plaintiff since, on their face, they purport to duplicate letters simultaneously sent to plaintiff (but cf. New York Hosp. Med. Ctr. of Queens v State Farm Mut. Auto. Ins. Co., 293 AD2d 588, 590-591 ; Great Wall Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co., 22 Misc 3d 136, 2009 NY Slip Op 50294 ).”
A statement of non-receipt brings forth a triable issue of fact. As to the “attorney argument”, the Court cites to NY Hosp., which states there should be communication between the provider and the attorney and to Great Wall where the Court went to great pains to state that counsel explicitly stated that (s)he represented EIP for purposes pf an EUO. I do not necessarily see the distinction here; I also question why the rule in marte-rosario which states that service of a letter on an attorney is sufficient to to impute knowledge to the EIP is not followed here. This panel makes up rules as it goes along.
Related Articles
- Understanding verification request mailing procedures in New York no-fault insurance claims
- When technical verification requirements override common sense in no-fault insurance
- The 150-day verification rule and timing requirements
- How equitable considerations affect no-fault verification disputes
- New York No-Fault Insurance Law practice area
Legal Update (February 2026): Since this 2014 post, Insurance Department Regulation § 65-3.8 governing verification procedures and tolling provisions may have been amended, and CPLR 2103 service requirements could have been modified. Additionally, subsequent appellate decisions may have further refined the standards for non-receipt affidavits and verification mailing procedures. Practitioners should verify current regulatory provisions and recent case law developments.
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. Analysis of Chapa...
Feb 25, 2026120-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, 2020Amended motion/Admissible Reply papers/Defects in affidavits/delay letter vs. verification requests
Court ruling on amended motions, defective IME affidavits, and delay letters vs. verification requests in New York no-fault insurance litigation procedures.
Aug 6, 2013The failure to respond to ALL of the requested verification renders lawsuit premature
New York court rules that partial compliance with additional verification requests renders no-fault insurance lawsuits premature, requiring complete response to all items.
Oct 18, 2010120-day rule rebutted
Court ruling shows affidavit alone can create triable issue on verification receipt despite 120-day rule, prompting questions about documentary evidence standards.
Nov 25, 2018Delay letters v. verification requests
New York court clarifies that generic delay letters don't toll statutory payment deadlines—only specific verification requests can extend an insurer's time to pay or deny claims.
Nov 28, 2015Common Questions
Frequently Asked Questions
What is additional verification in no-fault insurance?
Additional verification is a request by the insurer for more information to process a no-fault claim, authorized under 11 NYCRR §65-3.5. When the insurer sends a verification request, the 30-day clock for claim processing is tolled (paused) until the requested information is received. This is a common insurer tactic to delay payment — but the verification request must be timely and relevant to be valid.
How long does an insurer have to request additional verification?
Under the no-fault regulations, the insurer must request initial verification within 15 business days of receiving the claim. Follow-up verification requests must be made within 10 business days of receiving a response to the prior request. If the insurer fails to meet these deadlines, the verification request is invalid and cannot be used to toll the claim processing period.
What types of additional verification can a no-fault insurer request?
Under 11 NYCRR §65-3.5, insurers may request medical records, provider licensing documentation, proof of treatment rendered, tax returns or financial records (in certain fraud investigations), authorization for release of medical records, and signed NF-3 verification forms. The verification request must be relevant to the claim and not overly burdensome. Requests for information not reasonably related to claim processing may be challenged as improper.
What happens if I don't respond to a no-fault verification request?
Failure to respond to a timely and proper verification request can result in denial of your no-fault claim. Under 11 NYCRR §65-3.5(o), if the requested verification is not provided within 120 calendar days of the initial request, the claim is deemed denied. The 120-day period runs from the date of the original request. However, if the verification request itself was untimely or improper, the denial based on non-response may be challenged.
Was this article helpful?
About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
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.