No need to send letter to attorney

Historical note: Recover Medical Services was decided December 22, 2017, before this January 2018 note. Its result was split: late EUO requests defeated dismissal for one group of bills; the separate attorney-delay-letter argument failed as to the remaining three. The title is not a general rule dispensing with communications to counsel.

Last reviewed: September 2026.

The insurer did not win every bill in Recover Medical Services v Ameriprise Auto & Home. The Appellate Term rejected the provider’s attorney-notice argument for three bills, but held that the insurer’s EUO requests were too late to support dismissal of another group. Both parts belong in an accurate account of this December 22, 2017 decision.

Separate the two groups of bills

For bills received between January 26 and March 8, 2012, the insurer sent its EUO requests more than 30 days after receipt. It did not establish a timely toll that entitled it to summary judgment dismissing those claims as premature. The appellate court modified the order to deny that part of the insurer’s motion.

That was a denial of the carrier’s dismissal request, not a declaration that every issue concerning those bills had been decided for the provider. The timing problem had to be assessed for the particular claims covered by those receipt dates.

For the remaining three bills, the court affirmed dismissal. The provider’s argument that section 65-3.6(b) required a separate delay letter to its attorney did not defeat the verification defense in the circumstances described.

What Advantage Radiology actually held

Jason’s original note identified Advantage Radiology v Nationwide as the related decision. That February 15, 2017 opinion gives the attorney-notice issue a clearer factual setting.

There, the provider’s attorney had asked the insurer to send all claim communications to counsel. The insurer instead timely sent the initial and follow-up verification requests to the provider from whom the information was sought. The Appellate Term held that the insurer could comply with the regulations by directing those requests to that provider.

It also rejected the claim that a separate delay letter to the provider’s attorney was required where the plaintiff itself, rather than another person or entity, was the source of the requested verification. The court distinguished those situations instead of announcing that counsel never needs notice.

The title must be read with that limitation

“No need to send letter to attorney” is retained as the title of this historical post. Read literally outside its facts, it would be too broad.

Section 65-3.6(b) addresses follow-up and notification when verification remains outstanding. The identity of the person being asked to supply information matters. A request to a provider, a request to a patient and a communication about material sought from a third party are not interchangeable.

The decision likewise does not resolve every question about service of litigation papers, counsel’s representation in another proceeding or professional-conduct obligations. It concerns the effect of the particular claims-processing notice argument on the insurer’s verification defense.

What to check in a similar file

The file should show who was asked for each item, which address was used, when the bill arrived, when the request and follow-up were sent, and what counsel’s letter actually said. A file covering several bills should keep those receipt dates separate; a timely request for one does not establish timeliness for the others. An attorney’s involvement does not repair a late initial request. Conversely, addressing a proper request to the party required to answer it was not a defect in Advantage Radiology.

The Triangle R note addresses copies sent to an injured person when the underlying request was directed to a provider. Healing Health Products considers carbon copies to counsel and proof that the provider received the requests. Those are related but distinct notice records.

Why the timing half remains useful

South Nassau Orthopedic considers the deadline after a completed EUO. Recover Medical Services illustrates an earlier checkpoint: whether the insurer acted in time to obtain the claimed toll at all.

Check both when the request was sent and when the examination was completed. Focusing exclusively on the attorney-copy issue would hide the part of this appeal where the insurer’s own request dates defeated its motion.

Jason’s original commentary

The original comments below are retained as historical commentary. The case-specific corrections and later developments are explained above.

Upon review of my blog, I failed to note this case.

This case is just an off shoot of Advantage Radiology.

Connect to the Encyclopedia

Start with the no-fault verification hub and 2026 Chapa update for the governing framework and case directory. Related case notes:

• Mount Sinai v Dust Transit: the NF-5 and the missing follow-up.
• South Nassau Orthopedic: the clock after a completed EUO.
• Triangle R: provider requests and misaddressed assignor copies.
• Healing Health Products: detailed incoming-mail evidence.

For review of a particular no-fault verification dispute, request a Free Case Review. Keep the requests, responses and relevant claim dates available for that review.