The verifications were not mailed

Last reviewed: September 2026.

Historical note: This 2016 opinion concerns insufficient proof of request mailing, not a finding that the provider lost for failing to answer NF-10s. The DFS form list identifies an NF-10 as a denial; the 2026 verification hub explains the separate later denial-timing issue.

Auto One, the insurer, lost its motion for summary judgment in Daily Medical Equipment v Auto One, decided October 5, 2016. On two causes of action, its affidavits did not establish that verification requests had been mailed. The opinion does not find as a final fact that nothing was mailed, despite the shorthand headline.

Correcting the roles and the form

An NF-10 is the prescribed denial-of-claim form. It is not an initial verification request that a provider must answer. The form list in 11 NYCRR 65-3.4 distinguishes it from the application and verification forms.

The insurer moved to dismiss the provider’s action. For the second and third causes of action, it asserted that requested verification remained outstanding, making the claims premature. The appellate court found the insurer’s mailing affidavits insufficient and affirmed denial of its motion.

The earlier explanatory copy reversed the parties’ roles, described provider affidavits as the problem and called the gap fatal to the provider’s case. That account did not match the opinion. The court denied the insurer the requested dismissal; it did not grant the provider summary judgment for payment.

Jason’s original account of the affidavit problem

Jason described affidavits inherited from earlier counsel and the changes made after the loss:

These were affidavits I inherited from prior counsel. They explained NF-10s but did not mention Additional Verification requests. There was a residual catch all, but this did not work. But I mention this loss because after seeing it a few years ago, the affidavits were instantly fixed. This should be contrasted to all of the Alrof v. Safeco sightings we see where the court has already shot down certain affidavits and nobody attempts to fix, alter or ameliorate them. When people learn from their errors, they should be commended. Those that constantly repeat their mistakes are doomed to a life of mediocrity.

The published opinion does not reproduce those affidavits or describe their NF-10 language. Jason’s explanation remains attributed to his firsthand account. It helps explain why proof directed at one type of mailing may not establish another, but it is not a quotation from the court.

The references to other practitioners and Alrof in that passage are also Jason’s historical commentary. They are not findings made in Daily Medical and should not be enlarged into new accusations about unnamed attorneys.

A mailing foundation must address the disputed correspondence

The opinion cites St. Vincent’s Hospital v Government Employees Insurance. That case recognized an affidavit from an employee familiar with standard office procedures designed to ensure proper addressing and mailing.

The connection to the disputed item matters. Evidence explaining how denial forms are generated and sent does not necessarily explain how separate additional-verification requests are prepared and mailed. A general reference to office mail cannot be assumed to cover a procedure the witness never addresses.

Daily Medical gives the result, not a full specification for a replacement affidavit. A later reader should not claim that it required a particular postal service, software system or set of attachment labels. The problem identified by the court was insufficient proof of mailing on the insurer’s motion.

Why the first cause of action was separate

The court dealt with the first cause of action by referring to a companion decision, High Quality Medical Supplies v Mercury, issued the same day. That case rejected an argument that durable medical equipment absent from the fee schedule was necessarily uncompensable, noting the regulation addressing services not listed in a schedule.

That was a fee-schedule issue, not the verification-mailing issue affecting the other two claims. It does not justify treating the entire Daily Medical complaint as a single mailing dispute or adding a reimbursement amount not determined by the opinion.

The distinction is especially useful when reviewing a motion covering several bills. Identify which defense applies to each claim before assuming that an affidavit defect or companion citation explains every part of the order.

Mailing, nonreceipt and an unanswered request

Failure to establish mailing is different from proving mailing and then facing a denial of receipt. In Healing Health Products, the provider’s incoming-mail procedures and file searches raised a factual question about whether the insurer’s requests had been sent.

It is different again from City Care, where the providers’ own responses said some requested verification was not being supplied. In that situation, the court relied on the response’s content rather than a missing foundation for the insurer’s mailing.

These comparisons do not supply facts absent from Daily Medical. They show why the correspondence, the witness’s knowledge and the procedural stage all belong in an accurate case note.

What to take from the loss

An affidavit should be reviewed against the actual defense advanced: which request, which mailing procedure and which claim does it address? A denial form, a verification demand and a response are separate documents even when they appear in the same claim file.

The 2026 Chapa ruling on denial timing does not repair a missing mailing foundation. Nor does the no-fault regulation’s treatment of non-substantive defects establish that a request was mailed when the evidence is insufficient.

The practical value of Jason’s note is his identified correction to the affidavits after the loss. The legal result remains narrower: Auto One had not shown entitlement to dismissal on the papers before the court. Preserving that distinction avoids turning a useful practice lesson into a rule the court did not announce.

The distinction also survives the regulation’s treatment of minor defects. Section 65-3.8(h) addresses non-substantive, technical or immaterial defects in an NF-10 denial, while section 65-3.5(p) addresses defects in verification requests and notices. Those provisions concern the effect of defects; they are not evidence that a disputed mailing occurred. A properly completed form and a competent foundation for sending that form answer different questions. Daily Medical’s missing mailing proof should not be described as merely an imperfect box on an NF-10.

Connect to the Encyclopedia

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

• Colonia: correcting an affidavit did not cure a different proof defect
• Longevity: distinguish the bill from the verification response
• Compas/American Transit: separate evidence for separate claims
• City Care: responses expressly left verification unanswered

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