Key Takeaway
New York no-fault case clarifies burden of proof in additional verification disputes, showing how procedural missteps can doom otherwise valid claims.
Understanding Burden of Proof in Additional Verification Cases
In New York no-fault insurance litigation, disputes over additional verification requests frequently hinge on procedural requirements and burden of proof issues. These cases demonstrate how technical legal standards can determine the outcome of otherwise straightforward claims disputes. The additional verification process serves as a critical gatekeeping mechanism in no-fault insurance, allowing insurers to request additional documentation before paying claims.
When healthcare providers fail to properly establish their compliance with verification requests, courts will dismiss their claims regardless of the underlying merits. This principle reinforces the importance of maintaining detailed records and understanding procedural requirements in no-fault litigation.
Jason Tenenbaum’s Analysis:
Right Aid Med. Supply Corp. v State Farm Mut. Auto. Ins. Co., 2019 NY Slip Op 51409(U)(App. Term 2d Dept. 2015)
“At a nonjury trial held on February 26, 2016, the Civil Court noted that the only issue to be determined was whether plaintiff had provided the requested verification, stated that the burden was on plaintiff, and directed plaintiff to call its first witness. Plaintiff did not call any witnesses, arguing that the burden was on defendant to first establish that it had not received the requested verification. With no testimony having been presented, the Civil Court found for defendant on the ground that plaintiff had failed to demonstrate that it had provided the requested verification. Plaintiff appeals from a judgment entered March 21, 2016, dismissing the complaint.”
This is at most the follow-up to the Travelers case of last week.
Key Takeaway
The Right Aid Medical Supply case illustrates a fundamental principle in no-fault litigation: plaintiffs bear the burden of proving compliance with additional verification requests. Strategic missteps during trial, such as failing to present evidence while challenging verification non-receipt, can result in dismissal even when the underlying claim may have merit.
