A 65-3.2 sighting

A Significant Development in No-Fault Verification Disputes

A recent decision from the Appellate Term, First Department highlights an evolving trend in New York No-Fault Insurance Law litigation. The case of Village Medical Supply, Inc. v. Travelers Property Casualty Insurance Co. demonstrates how insurance carriers are increasingly invoking regulation 11 NYCRR 65-3.2(c) as a defensive tool against claims that their verification requests lack “good reason.”

This development is particularly noteworthy because it represents a shift in how verification disputes are being argued and decided. While carriers have traditionally defended verification requests on various grounds, the explicit citation of section 65-3.2(c) provides a more structured framework for these defenses. Understanding this regulatory provision becomes crucial for practitioners navigating the complex landscape of no-fault claims, especially when dealing with medical supply disputes that often involve detailed documentation requirements.

Jason Tenenbaum’s Analysis:

Village Med. Supply, Inc. v Travelers Prop. Cas. Ins. Co., 2018 NY Slip Op 51311(U)(App. Term 1sr Dept, 2018)

“Defendant-insurer established its prima facie entitlement to summary judgment dismissing the underlying first-party no-fault claims as premature, since the record conclusively establishes that plaintiff failed to respond to timely requests for verification (see St. Vincent Med. Care, P.C. v. Country Wide Ins. Co., 80 AD3d 599, 600 ). No triable issue was raised by plaintiff’s claim that defendant had no “good reason” (11 NYCRR 65-3.2) for its verification request for a manufacturer’s invoice documenting the cost of the supplies provided to the assignor (see New Way Med. Supply Corp. v State Farm Mut. Auto Ins. Co., 56 Misc 3d 132, 2017 NY Slip Op 50925 ; see also 12 NYCRR 442.2).”

So while this was a win for the insurance carrier, 3.2(c) now serves as a basis to defeat a verification request. My study of this area of law has shown fleeting citations of 3.2(c), but now it is clearly in vogue.

Key Takeaway

The Village Medical Supply decision signals that 11 NYCRR 65-3.2(c) is becoming a mainstream defense strategy for insurance carriers facing verification challenges. This regulatory provision, once rarely cited, is now gaining prominence as a tool to justify verification requests and counter claims of “good reason” deficiencies in no-fault litigation.

Related Articles

• Understanding Medical Billing and Down-Coding in New York No-Fault Insurance Claims
• First application of 11 NYCRR 65-3.8(g)(1)(ii)
• Fee Schedule Defense Requirements in No-Fault Insurance Cases
• Fee schedule defense – competent evidence?
• New York No-Fault Insurance Law

Legal Update (February 2026): Since this post’s publication in 2018, the no-fault fee schedule regulations under 11 NYCRR 65-3 may have been subject to amendments or revisions that could affect verification procedures and good reason standards. Additionally, subsequent appellate decisions may have further developed the interpretation of section 65-3.2(c) beyond the Village Medical Supply precedent. Practitioners should verify current regulatory provisions and review recent case law developments when analyzing verification dispute strategies.