Key Takeaway
Court ruling on non-receipt denials and verification requirements in NY no-fault insurance claims, including burden of proof standards for medical providers.
Longevity Med. Supply, Inc. v Praetorian Ins. Co., 2015 NY Slip Op 50401(U)(App. Term 2d Dept. 2015)
(a) As to non-receipt
“efendant’s mere denial of receipt of was insufficient to rebut the presumption of receipt established by plaintiff’s proof of mailing” (see Compas Med., P.C. v Farm Family Cas. Ins. Co., 38 Misc 3d 142, 2013 NY Slip Op 50254, *2 ). Thus, defendant failed to raise a triable issue of fact with respect to plaintiff’s first cause of action.”
The law requires a detailed discussion as to how the conclusion of non-receipt was reached.
(b) As non-receipt of verification
“Defendant demonstrated prima facie that it had not received the requested verification and thus that plaintiff’s second cause of action is premature (see 11 NYCRR 65-3.8 ; Central Suffolk Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492 ). However, in opposition to the cross motion, plaintiff submitted an affidavit from one of plaintiff’s employees, which affidavit was sufficient to give rise to a presumption that the requested verification had been mailed to and received by defendant”
This is conclusory affidavit where the biller says they sent the verification but never actually presents proof that the verification was complied with. How can this document raise an issue of fact?
Related Articles
- Again – a mere denial will not rebut proof that a verification demand was mailed
- Understanding Verification Requests in New York No-Fault Insurance Claims
- Affidavits of Non-Receipt and Default Judgment Procedures in NY Personal Injury Cases
- Mailed to the wrong address – okay
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2015 post, 11 NYCRR 65-3 has undergone multiple amendments, particularly regarding verification procedures and documentation requirements for non-receipt claims. The regulatory framework governing billing disputes and verification protocols may have been substantially modified. Practitioners should verify current provisions of 11 NYCRR 65-3.8 and related sections, as procedural requirements for establishing non-receipt and verification standards may differ from those discussed in the cited cases.
