Key Takeaway
Seven court cases show Allstate's repeated failure to prove timely mailing of claims documents, highlighting a critical issue in no-fault insurance litigation.
When Insurance Companies Can’t Prove They Sent What They Say They Sent
In no-fault insurance litigation, timing is everything. Insurance companies must follow strict deadlines when issuing claim denials, requesting additional documentation, or scheduling examinations. But what happens when an insurer claims they sent important documents on time, yet cannot prove the mailing actually occurred when they said it did?
This fundamental issue of proof in mailing disputes has significant implications for healthcare providers seeking payment for services rendered to accident victims. When insurance companies fail to establish proper mailing procedures or maintain adequate records, their ability to enforce statutory deadlines comes into question. The burden of proving timely mailing falls squarely on the insurance company, and as these cases demonstrate, that burden isn’t always met.
Understanding these procedural requirements becomes especially important when dealing with certified mail versus regular mail in insurance communications.
Jason Tenenbaum’s Analysis:
Acupuncture Healthcare Plaza I, P.C. v Allstate Ins. Co., 2017 NY Slip Op 51903(U)(App. Term 2d Dept. 2017)
Renelique v Allstate Ins. Co., 2017 NY Slip Op 51884(U)(App. Term 2d Dept. 2017)
Compas Med., P.C. v Allstate Ins. Co., 2017 NY Slip Op 51842(U)(App. Term 2d Dept. 2017)
Healing Art Acupuncture, P.C. v Allstate Ins. Co., 2017 NY Slip Op 51821(U)(App. Term 2d Dept. 2017)
Big Apple Ortho Prods., Inc. v Allstate Ins. Co., 2017 NY Slip Op 51791(U)(App. Term 2d Dept. 2017)
KHL Acupuncture, P.C. v Allstate Ins. Co., 2017 NY Slip Op 51709(U)(App. Term 2d Dept. 2017)
Charles Deng Acupuncture, P.C. v Allstate Ins. Co., 2017 NY Slip Op 51716(U)(App. Term 2d Dept. 2017)
Key Takeaway
These seven Appellate Term decisions from 2017 reveal a pattern of Allstate’s inadequate record-keeping regarding mail procedures. When insurance companies cannot substantiate their claims of timely mailing, courts may rule in favor of healthcare providers, potentially invalidating the insurer’s defenses and leading to claim approvals that might otherwise have been denied.
