Non receipt and verification

Last reviewed: September 2026.

Historical note: Longevity resolved two different mailing issues in 2015. Read its claim-by-claim result alongside the 2026 verification hub; Chapa’s later denial-timing ruling does not decide whether a particular bill or response was mailed.

Nonreceipt of a bill and nonreceipt of requested verification are not the same defense. In Longevity Medical Supply v Praetorian, decided March 17, 2015, the provider won summary judgment on its first cause of action. On the second, it defeated the insurer’s motion but did not obtain judgment for payment.

The first cause: the insurer’s denial of bill receipt

The provider’s owner supplied sufficient evidence to establish its prima facie entitlement to judgment on the first claim. The insurer’s mere denial of receiving that claim did not rebut the presumption created by the provider’s mailing proof.

The result was affirmative relief for the provider on that cause of action. The opinion does not turn every nonreceipt affidavit into inadequate evidence; it identifies the deficiency in the opposition submitted on this record.

The original post added that the law requires a detailed explanation of how nonreceipt was determined. That is useful practical commentary, but this decision does not prescribe a universal list of computer searches, witnesses or exhibits. An explanation of the actual mail system and the witness’s knowledge is different from inventing a mandatory checklist attributed to the court.

The second cause: the provider’s response evidence

The insurer made a prima facie showing that it timely mailed initial and follow-up verification requests and had not received the requested material. The provider opposed with an employee affidavit that the court found sufficient to create a presumption that the response had been mailed and received.

This left a factual question about prematurity. It did not give the provider summary judgment on the second cause of action or establish final compliance with every request. The appellate order denied the insurer’s cross-motion while granting the provider relief only on the first claim.

These outcomes are easy to lose when both are summarized as “nonreceipt.” In the first, the insurer was contesting receipt of the underlying claim. In the second, the insurer had requested information and the provider offered proof of its response.

Jason’s original observation

Jason’s two original observations are preserved in their original order:

The law requires a detailed discussion as to how the conclusion of non-receipt was reached.

He then questioned the response affidavit:

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?

The published opinion does not reproduce the affidavit or list its attachments. It says the employee’s affidavit was sufficient to raise the mailing-and-receipt presumption. Jason’s criticism is preserved as his assessment, not transformed into a court finding that there was no evidence or that the response was invented.

Why the comparison is about evidence, not a double standard

St. Vincent’s Hospital v Government Employees Insurance accepted an insurer employee’s knowledge of standard office procedures as mailing evidence. Its rule is not reserved for a provider or an insurer, and a certified-mail receipt is not invariably the only route to a presumption.

Healing Health Products involved a different affidavit: the provider described how incoming mail was recorded and how its computer and physical files had been searched. The resulting nonreceipt evidence raised a question about the insurer’s mailing of requests.

Those examples explain why “we did not receive it” can describe very different evidentiary submissions. A bare denial and a witness’s account of a specific record search are not interchangeable. Nor is a factual dispute resolved merely by deciding which party has the more detailed-looking template.

Separate the three mailings

In a verification file, the original bill travels from provider to insurer. A request travels in the opposite direction. A response then travels back to the insurer. Each mailing has its own contents, date and potential evidence.

For the bill, the question may be whether the insurer’s time to act began. For the request, the question may be whether the insurer established the verification process on which it relies. For the response, the issue may be whether material remained outstanding. Longevity addresses the first and third questions on separate causes of action.

As an organizational aid, identify the disputed document beside each affidavit before applying the cited cases. Evidence about an office’s handling of bills does not automatically describe how it handles every other item. This is a reading method, not a finding that either party in Longevity used an identical procedure for all correspondence.

What later law adds

11 NYCRR 65-3.8 addresses payment or denial and relevant verification. Its 120-day provisions require attention to possession or control, written reasonable justification and the warning given in the request; they are not a replacement for evidence that the correspondence was sent.

Chapa in 2026 rejected an added mandatory 150-day denial deadline. The insurer there had issued denials. Nothing in that holding decides whether the provider in Longevity mailed its response, and nothing makes the two causes of action here share the same outcome.

The enduring value of this note is the distinction between winning payment and keeping a claim alive for factual determination. Both occurred in one appeal, but on different claims.

Longevity also identifies who supplied the evidence: the provider’s owner supported its first claim; an employee supplied the response affidavit on the second; the insurer relied on its claims examiner for the verification defense. Their roles explain which propositions the court evaluated. The case does not say that ownership alone proves every mailing or that an employee needs no factual foundation. Reading the affidavits as evidence directed to particular claims avoids those unsupported shortcuts.

Connect to the Encyclopedia

Start with the verification requirements hub: Chapa, response evidence and denial timing. For the related historical decisions:

• Compas/American Transit: an insurer affidavit did create a receipt dispute
• Compas/Praetorian: split results on verification and examination defenses
• Daily Medical: proof of request mailing failed
• Solution Bridge: claimed response mailing contested a denial

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