Key Takeaway
Court denies plaintiff's motion in no-fault case due to failed verification compliance and assignor's failure to appear for required IMEs and EUOs.
This article is part of our ongoing additional verification coverage, with 403 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.
Compas Med., P.C. v Praetorian Ins. Co., 2015 NY Slip Op 51467(U)(App. Term 2d Dept. 2015)
“The Civil Court denied plaintiff’s motion, granted the branch of defendant’s cross motion seeking summary judgment dismissing plaintiff’s third cause of action as premature because plaintiff had failed to provide requested verification, and granted the branches of defendant’s cross motion seeking summary judgment dismissing the remaining causes of action due to the failure of plaintiff’s assignor to appear for independent medical examinations (IMEs) and examinations under oath (EUOs).
In support of the branch of defendant’s cross motion seeking summary judgment dismissing plaintiff’s third cause of action, defendant submitted an affidavit by its claims examiner which established that defendant had timely mailed its verification request and follow-up verification request (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 ). Defendant demonstrated prima facie that it had not received the requested verification and thus that plaintiff’s third 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 ). As plaintiff failed to raise a triable issue of fact, the Civil Court properly granted the branch of defendant’s cross motion seeking summary judgment dismissing this cause of action.”
My case. Thank you. On this one, there was no affidavit attempting to explain the verification compliance.
Legal Significance: Layered Compliance Defenses
The Compas Medical decision illustrates a critical strategic reality in no-fault litigation: carriers need prevail on only one defense to defeat a provider’s claim. Praetorian Insurance asserted three separate defenses—verification non-compliance, IME no-shows, and EUO no-shows. The court addressed the verification defense first, finding it dispositive of one cause of action, then addressed the examination no-shows separately for remaining causes of action.
This layered defense strategy creates significant challenges for providers. Even if a provider could overcome the verification defense, it still must defeat both the IME and EUO no-show defenses. Each defense requires different proof and raises distinct legal issues. Verification involves documentary evidence of what was requested and what was provided. IME no-shows require proof of proper notice, reasonably convenient scheduling, and actual non-appearance. EUO no-shows similarly demand evidence of proper notice and non-appearance. For providers to prevail, they must successfully refute every procedural defense the carrier asserts. One failure dooms the entire case. This asymmetry favors insurers, who can assert multiple defenses knowing that success on any single defense achieves their litigation objective.
Practical Implications for Healthcare Providers
The Compas Medical decision underscores the importance of meticulous compliance with all no-fault procedural requirements. Providers cannot afford to ignore verification requests while focusing on examination appearances, or vice versa. Every procedural demand from the carrier must be addressed comprehensively and documented carefully. When providers receive verification requests, they should respond completely and retain proof of their responses. When examination notices arrive, providers must ensure claimants appear or have documented excuses for non-appearance. The failure to comply with any single requirement can result in dismissal regardless of how strong the provider’s substantive case may be. This case also demonstrates why carriers often prefer multiple procedural defenses over substantive medical necessity challenges. Procedural defenses are often easier to prove, requiring only evidence of requests and non-compliance rather than expert medical testimony about treatment appropriateness.
Related Articles
- Additional verification not produced is probative of nothing
- Triable issue of fact as to non-appearance?
- EUO no-show and verification non-receipt
- No-show failed the Alrof test
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2015 post, 11 NYCRR 65-3 has undergone several amendments affecting verification requirements, EUO procedures, and IME scheduling protocols. Practitioners should verify current provisions regarding notice requirements, timeframes for compliance, and procedural safeguards, as regulatory changes may have modified the standards applied in no-show determinations.
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.
403 published articles in Additional Verification
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More Additional Verification Analysis
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Feb 25, 2026No Denial Required When Provider Fails to Respond to Verification Within 120 Days
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Feb 25, 2026Certified Mail and Regular Mail
New York court clarifies that EUO scheduling letters sent by regular mail are sufficient - certified mail is not required for valid examination under oath notices.
Jul 24, 2019The EUO bust statement as a business record
Learn how EUO bust statements can serve as admissible business records in NY no-fault insurance cases, including court analysis and practical litigation tips.
Jul 7, 2016Alrof”t” (read the cited to decisions)
Two conflicting New York Civil Court decisions highlight ongoing debate over EUO no-show requirements and proper practice procedures in no-fault insurance cases.
Oct 4, 2014An attorney's statement, i.e., "he did not show up" is sufficient to support EUO defense
New York court ruling confirms attorney affirmations stating claimants failed to appear at EUOs are sufficient evidence to establish no-show defense in no-fault cases.
Apr 8, 2012Common 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.
What is an Examination Under Oath (EUO) in no-fault insurance?
An EUO is a sworn, recorded interview conducted by the insurance company's attorney to investigate a no-fault claim. The insurer schedules the EUO and asks detailed questions about the accident, injuries, treatment, and the claimant's background. Under 11 NYCRR §65-3.5(e), appearing for the EUO is a condition precedent to receiving no-fault benefits — failure to appear can result in claim denial.
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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.