120-day rule rebutted

Last reviewed: September 2026.

Legal Update (September 2026): Chapa, 245 AD3d 880, rejected a mandatory 150-day denial deadline; it did not remove the need to prove the verification defense. See the updated verification hub. Solution Bridge’s 2018 result concerned a factual dispute over the response.

The 120-day rule was not struck down in Solution Bridge v State Farm. On November 16, 2018, the Appellate Term reversed summary judgment for the insurer because the provider’s affidavit raised a factual question about whether it had supplied verification. The claim remained disputed; the provider was not awarded payment by that order.

What State Farm established initially

The insurer moved to dismiss based on the provider’s failure to supply requested verification within 120 days. The court found its proof sufficient, at the initial stage, on timely mailing of initial and follow-up requests, nonreceipt of the requested material and timely denial on that ground.

The provider’s opposition then supplied an affidavit that the court found sufficient to create a presumption of mailing and receipt of the verification. That evidence prevented a final determination for the insurer on the motion.

The published opinion does not identify the affiant as an employee, reproduce the affidavit or say whether certified-mail receipts or response copies were attached. The previous explanatory copy treated those details as established facts. The case itself supports the narrower statement that the opposition created a factual issue.

What the reversal did and did not decide

The Appellate Term denied State Farm’s summary-judgment motion. It did not decide conclusively that verification arrived, find that the insurer acted dishonestly or declare the provider’s medical charges payable.

The headline is best understood as a defense being contested on its facts. It is not an announcement that the regulation was repealed or that an affidavit automatically excuses missing the response period.

A motion result and a final factual determination answer different questions. The insurer had a sufficient initial showing; the opposition made the disputed mailing unsuitable for resolution in the insurer’s favor on those papers. That is why the opinion identifies both stages rather than simply saying that the insurer failed to prove anything.

Jason’s original November 2018 comment

Jason’s objection to the evidentiary result remains in his original words:

Has anyone sought to ask the Second Department to review these cases? i am hard-pressed to imagine that an affidavit without documentary support is sufficient to raise an issue of fact. Or, are we all sheep?

His criticism does not change the appellate disposition. It is also not independent proof of the affidavit’s contents. The public decision states that the affidavit supported a presumption; it does not characterize the evidence as fabricated or announce that documentary support is categorically unnecessary.

Mailing proof is not limited to a postal receipt

The cited St. Vincent’s Hospital decision recognized testimony about standard office practices designed to ensure proper addressing and mailing. That matters because the old copy incorrectly insisted that actual mailing proof must take the form of a postal receipt or similar document.

CPLR 4518(a) concerns the admissibility of business records made in the regular course of business at or within a reasonable time of the event. It does not, by itself, create a universal presumption that all insurer records are correct or that a provider affidavit cannot be considered.

The questions are what evidence was offered, whether it has the required foundation and what fact it tends to establish. A record showing no response logged and an affidavit describing a mailing may create a dispute; neither can be evaluated solely by its label.

Read the 120-day provision with its conditions

11 NYCRR 65-3.5(o) addresses production of verification under the applicant’s control or possession, or written proof providing reasonable justification for failure to comply. The insurer must advise the applicant of the potential denial consequences. Section 65-3.8(b)(3) addresses the corresponding denial mechanism.

Those particular provisions exclude prescribed NF forms, IMEs and EUOs. Their applicability also depends on the treatment/service or accident date specified in the text. A 2018 publication date alone does not establish every element for a different claim.

Solution Bridge says the insurer met its initial burden on the record before it. It does not authorize a reader to skip the request, warning, mailing and response evidence when applying the regulation elsewhere. A dispute over whether material was supplied is also different from an argument that nonproduction had a reasonable justification.

The earlier TAM comparison

TAM Medical Supply v Tri State Consumers, decided September 22, 2017, reached a similar motion result. The insurer established nonreceipt initially, but the provider’s opposition created a presumption that verification had been mailed and received. The insurer’s dismissal motion was denied.

TAM helps place Solution Bridge in a sequence of factual-dispute decisions rather than treating it as an isolated change in the regulation. Neither short opinion reproduces the provider’s complete affidavit. Neither resolves a calculated 150-day denial deadline. A reader interested in that later timing question needs Chapa; a reader interested in the disputed response needs the mailing evidence described in these earlier opinions.

What changed in Chapa, and what did not

The 2026 Chapa opinion rejected an additional mandatory 150-day deadline for denying a claim based on missing verification. It restored the insurer’s summary-judgment result in a case where denials had been issued.

That holding concerns denial timing. Solution Bridge concerns competing evidence of a response. A timely or otherwise sustainable denial does not make a contested fact disappear, and the existence of a factual dispute does not repeal the underlying regulation.

The paired readings give a useful sequence for reviewing a claim: first identify the asserted defense and its legal requirements, then test the evidence for each element, then distinguish any unresolved factual question from the separate deadline argument. This sequence is explanatory guidance, not a claim that either opinion decided every possible verification dispute.

Connect to the Encyclopedia

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

• Compas/Praetorian: an owner affidavit preserved one claim for factual resolution
• Longevity: different results for bill receipt and response receipt
• City Care: express nonproduction rather than a disputed mailing
• Daily Medical: the insurer did not establish that requests were mailed

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