Key Takeaway
Court ruling shows how medical providers can counter insurance company claims of non-receipt through proper affidavit evidence in no-fault verification disputes.
No-fault insurance disputes often hinge on seemingly mundane procedural questions that can have significant financial consequences. One recurring battleground involves verification requests — when insurance companies claim they never received required documentation from medical providers, potentially allowing them to deny claims. The case of New Way Med. Supply Corp. v State Farm illustrates how the burden of proof can shift in these verification disputes, and why proper documentation practices are crucial for both sides.
This case demonstrates the chess match that often unfolds in New York no-fault insurance law when insurers assert additional verification non-receipt. While insurance companies may establish a prima facie case through claims examiner affidavits, medical providers aren’t powerless to respond. The outcome often depends on who can present more compelling evidence about what was actually mailed and received.
Jason Tenenbaum’s Analysis:
New Way Med. Supply Corp. v State Farm Mut. Auto. Ins. Co., 2015 NY Slip Op 51678(U)(App. Term 2d Dept. 2015)
“In support of the branch of defendant’s cross motion seeking summary judgment dismissing the second 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 ). Defendant also 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 plaintiff’s employee, which affidavit was sufficient to give rise to a presumption that the requested verification had been mailed to, and received by, defendant”
Key Takeaway
Even when an insurance company establishes through affidavit testimony that it properly requested verification but never received it, medical providers can counter this defense by presenting their own sworn evidence of mailing. The court’s emphasis on the employee’s affidavit shows that verification non-receipt disputes often come down to competing credibility assessments rather than clear documentary proof.
Legal Update (February 2026): Since this post’s publication in November 2015, the regulatory framework under 11 NYCRR 65-3, particularly section 65-3.8 governing verification procedures, may have been subject to amendments or interpretative guidance updates. Additionally, subsequent appellate decisions may have further refined the evidentiary standards and burden-shifting analysis for verification non-receipt disputes. Practitioners should verify current regulatory provisions and recent case law developments when handling similar verification disputes.
