Key Takeaway
Court allows bare "I responded to verification" affidavit to defeat summary judgment motion, despite no actual verification documents being submitted as evidence.
The Problem with Bare Affidavits in No-Fault Verification Disputes
In New York no-fault insurance litigation, verification requests serve as a critical tool for insurers to validate medical claims. When healthcare providers fail to respond to these requests, insurers can deny payment based on lack of compliance. However, a troubling trend has emerged where courts accept minimal evidence from providers claiming they did respond to verification requests.
The case below illustrates how courts sometimes allow healthcare providers to defeat summary judgment motions with nothing more than a conclusory affidavit stating they responded to additional verification requests—without actually producing any evidence of that response.
This creates significant problems for insurers trying to enforce legitimate verification requirements under New York No-Fault Insurance Law.
Jason Tenenbaum’s Analysis:
Compas Med., P.C. v American Tr. Ins. Co., 2015 NY Slip Op 51240(U)(App. Term 2d Dept. 2015)
“As to the remaining causes of action, defendant’s cross motion was sufficient to make a prima facie showing that plaintiff had failed to respond to defendant’s initial and follow-up requests for verification as to the claims upon which these causes of action were based. However, as plaintiff argues on appeal, plaintiff’s opposition was sufficient to raise a triable issue of fact as to whether plaintiff had responded to those verification requests. Therefore, neither party is entitled to summary judgment on these causes of action”
Of course, the responded to verification was not included in the papers before Civil Court. Rather, the Rybak “I responded to verification” affidavit without anything more was sufficient to defeat the motion. This decision and all the others on the same conclusory bald affidavit are 7 shades short of insane.
Key Takeaway
Courts are increasingly accepting bare affidavits from healthcare providers claiming they responded to verification requests, even when no actual verification documents are submitted as evidence. This trend undermines the verification process and creates verification non-receipt issues that make it difficult for insurers to properly adjudicate claims.
