Key Takeaway
Court confirms General Construction Law timing rules apply to no-fault denials, emphasizing proper mailing procedures and calculation of deadlines in insurance disputes.
This article is part of our ongoing timeliness of requests coverage, with 15 published articles analyzing timeliness of requests 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.
No-fault insurance disputes often hinge on precise timing requirements and proper procedural compliance. When insurance companies deny claims, they must follow specific rules about how and when those denials are communicated. The General Construction Law provides crucial guidance on calculating deadlines and determining when notices are considered properly delivered.
In healthcare provider cases, establishing proper mailing procedures can make or break a case. Insurance companies must demonstrate not only that they sent required notices, but that they followed established protocols for doing so. This becomes particularly important when disputes arise about whether denials were timely or contained the necessary legal language.
The interplay between mailing procedures and deadline calculations frequently determines case outcomes. Courts scrutinize both the substance of denials and the procedural mechanics of their delivery, applying General Construction Law principles to resolve timing disputes.
Jason Tenenbaum’s Analysis:
Tam Med. Supply Corp. v Citiwide Auto Leasing, 2016 NY Slip Op 50748(U)(App. Term 2d Dept. 2016)
“Contrary to plaintiff’s arguments on appeal, defendant established a proper practice and procedure of mailing of its denials (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 ), and that the denials containing the requisite language had been timely mailed (see General Construction Law §§ 25, 25-a; VS Care Acupuncture v State Farm Mut. Auto. Ins. Co., 46 Misc 3d 141, 2015 NY Slip Op 50164 ; see also General Construction Law § 20 he day from which any specified period of time is reckoned shall be excluded in making the reckoning”]). Plaintiff’s remaining contention as to defendant’s cross motion lacks merit. Thus, we leave the granting of defendant’s cross motion undisturbed.”
Key Takeaway
This decision reinforces that insurance companies can successfully defend denial challenges by demonstrating proper mailing procedures and compliance with General Construction Law timing requirements. The court’s analysis shows how procedural compliance, combined with proper application of deadline calculation rules, can dispose of provider challenges to claim denials. Similar principles apply in cases involving examination under oath procedures where personal knowledge requirements become crucial to establishing proper notice.
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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.
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Dec 8, 2013Common Questions
Frequently Asked Questions
What are the deadlines for insurer verification requests?
Under 11 NYCRR §65-3.5, the insurer must issue its initial verification request within 15 business days of receiving a claim. Follow-up requests must be issued within 15 business days of receiving a response. These deadlines are strictly enforced — late requests do not toll the insurer's 30-day obligation to pay or deny the claim.
What happens if the insurer sends a late verification request?
If the insurer misses the 15-business-day deadline, the verification request is untimely and does not toll the 30-day pay-or-deny period. The claim becomes overdue, and the insurer must pay with 2% per month statutory interest. This is one of the most common issues litigated in no-fault cases.
How does timeliness of requests affect claim denials?
An untimely verification request means the insurer lost its right to request that information, and the 30-day clock for paying or denying the claim continued to run. If the insurer then denies the claim based on information it should have requested timely, that denial may be overturned as untimely itself.
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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 timeliness of requests 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.