Another less than valid verification compliance affidavit suffices

Last reviewed: September 2026.

Historical note: This 2015 appeal changed the result on one verification claim, not the five IME/EUO claims. The 2026 verification hub explains the later denial-timing issue and the separate treatment of examination requests under the regulation.

The provider won only part of this appeal. In Compas Medical v Praetorian, decided November 19, 2015, a response-mailing affidavit raised a factual issue on the first cause of action. Dismissal of the second through sixth causes remained in place on IME and EUO nonappearance grounds.

The first claim: competing proof about verification

The insurer’s claims examiner established timely mailing of an initial verification request and a follow-up request, together with nonreceipt of the requested verification. That was sufficient for the insurer’s initial showing that the first cause of action was premature.

The provider’s owner then submitted an affidavit that the court found sufficient to create a presumption that the requested verification had been mailed and received. This raised a factual issue concerning the first claim. The Appellate Term denied the insurer’s request for summary judgment on that cause of action.

The court did not grant the provider payment on that claim. It also did not reproduce the owner’s affidavit, describe all its attachments or state that it accepted a knowingly false account. Those matters should not be supplied by an explanatory paragraph as though they were findings in the published decision.

The five other claims: different defenses, different result

The second through sixth causes of action involved the assignor’s failure to attend IMEs and EUOs. The court found that the insurer established timely mailing of the scheduling letters, nonappearance at the duly scheduled examinations and timely denials on that ground. The provider failed to raise a factual issue in response.

Those dismissals were affirmed. A provider’s success in creating a dispute over documentary verification therefore did not eliminate the insurer’s independently established examination defenses. Omitting this half of the opinion gives a misleading picture of the result.

The published order modified only the branch dismissing the first cause of action. When citing Compas, match the proposition to that branch rather than describing the entire complaint as reinstated.

Jason’s original November 2015 reaction

Jason’s original note criticizes the affidavit he says he read. It is preserved below as his contemporaneous reaction, not as an appellate finding about the truth of a mailing:

I read the affidavit. There is nothing except boilerplate about submitting verification responses to the carrier. Noteworthy, there is nothing provided showing wen the verification was mailed and what was mailed. Why? It never happened. I would hope after seeing the same affidavit, this Court would wake up and ask themselves why they are reversing close to 100 matters where judges found the plaintiff affidavit to be deficient. One day someone on the 15th floor will get it.

The public opinion does not reproduce that affidavit or substantiate the assertion that the mailing never happened. Its stated conclusion is narrower: the affidavit created a presumption and a factual issue. The original criticism and that legal result must remain visibly separate.

Presumption of receipt is not a final finding of compliance

St. Vincent’s Hospital v Government Employees Insurance recognizes evidence based on knowledge of standard office mailing procedures. That is why a case cannot accurately be reduced to “no postal receipt, therefore no proof.”

At the same time, calling a document an affidavit does not establish its adequacy. The witness’s knowledge, the procedure described and its connection to the disputed correspondence all matter to the proof being offered. Compas assessed the submissions before it; it did not approve a form for every later case.

Healing Health Products, also cited in the decision, concerned a provider’s evidence about its incoming-mail records and searches. That distinct record raised a question about whether the insurer had mailed requests at all. It should not be confused with a provider’s claim that it mailed the requested response.

Documentary requests and examination requests are not interchangeable

The DFS verification provisions distinguish several request types. Sections 65-3.5(o) and 65-3.8(b)(3) contain the 120-day additional-verification mechanism but expressly exclude prescribed NF forms, IMEs and EUOs from those particular provisions.

That distinction helps explain why a current reader should keep the first cause of action separate from the other five. This note is not a new determination of the validity of every examination notice or a calculation of the deadlines for a different claim.

Chapa’s 2026 rejection of a mandatory 150-day denial deadline addresses another question again. It does not excuse proof of mailing, decide whether verification was supplied, or turn the five examination dismissals here into documentary-verification rulings.

Using the case without losing its limits

For a multiple-bill complaint, set out each cause of action, its defense, the supporting witness and the opposing evidence. The first claim in Compas had competing mailing evidence; the remaining claims had unrebutted examination proof as the court described it.

This is also why a motion being denied should not be reported as a final finding that a response was sent. The factual issue remained unresolved. Preserving that distinction gives this historical note value beyond its strongly worded headline.

The Civil Court order was entered in March 2013, before the April 2013 commencement date specified for parts of the amended verification rules. The November 2015 appeal date does not establish treatment dates, request dates or applicability of a new provision. A current filing should identify those dates from its own record instead of importing the 120-day mechanism merely because this opinion discusses verification.

Connect to the Encyclopedia

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

• Compas/American Transit: separate bill and response disputes
• Longevity: payment on one claim, a factual dispute on another
• Solution Bridge: mailing evidence contested a 120-day defense
• City Care: responses expressly left requests unanswered

For review of a particular no-fault dispute, request a Free Case Review.