Who Bears the Burden of Proving Verification Compliance at a No-Fault Trial?

Historical note: Right Aid reversed the dismissal and ordered a new trial on August 23, 2019, following Island Life. The earlier account on this page incorrectly said the appellate court affirmed and placed the initial trial burden on the provider.

Last reviewed: September 2026.

The provider won a new trial in Right Aid Medical Supply Corp. v State Farm Mutual Automobile Insurance Co. The Appellate Term did not affirm dismissal after the provider declined to call a witness. It reversed, applying the reasoning of the companion Island Life decision. That distinction changes the point of this entire case note.

What had already been decided before trial

A November 19, 2014 order established that the insurer had timely requested additional verification. The remaining dispute concerned whether the requested verification had been supplied.

This is the role of a limited-issue order under CPLR 3212(g): facts established on the summary-judgment record can narrow what remains for trial. The earlier ruling did not, merely by settling mailing, establish nonreceipt of the requested response.

The previous version of this page treated those separate facts as though both had been established. Proof that a request was mailed and proof that the requested information was not received answer different questions.

The Civil Court’s ruling was the ruling reversed

At the February 26, 2016 nonjury trial, the Civil Court directed the provider to call its first witness. The provider declined, arguing that the insurer first had to establish nonreceipt of the requested verification. With no testimony presented, the Civil Court found for the insurer. Judgment dismissing the complaint was entered on March 21, 2016.

That is the procedural history, not the appellate holding. On August 23, 2019, the Appellate Term reversed the judgment and sent the case back for a new trial.

Quoting only the paragraph that describes the unsuccessful trial appearance can produce the opposite of the reported result. The final disposition and the court’s reference to Island Life are essential to understanding why this opinion matters.

What the companion Island Life decision explains

Island Life Chiropractic v Travelers, decided August 2, 2019, addressed the burden where earlier motion practice had already narrowed the verification issues. It rejected making the provider establish compliance before the insurer presented its remaining proof of nonreceipt.

Right Aid followed that reasoning. It therefore does not support a universal statement that the provider must open the proof whenever the trial issue is phrased as whether verification was supplied.

Nor did the reversal award the provider payment of the bills. A new trial leaves the unresolved factual issue to be tried. A provider that wins a burden-allocation appeal still needs to understand what proof may be required once the opposing party makes its showing.

Why preserving the record still matters

Counsel should identify the exact facts established by the prior order, the issue left open and the ruling allocating the burden. Those documents let a reviewing court distinguish an incorrect burden ruling from a failure to prove a fact that actually remained the party’s responsibility.

This is not a general recommendation to refuse to call witnesses. The original litigation demonstrates a successful appellate objection on a specific record, not a risk-free trial tactic. Likewise, describing a verification defense as “permanent abeyance” goes beyond this decision and ignores the need to establish the applicable requests and outstanding items.

For comparison, Healing Health Products held that neither side had the favorable limited-issue ruling they assumed. SS Medical Care involved an unopposed, supported carrier cross-motion. Read the prior order before deciding what either side must prove at trial.

Frequently Asked Questions

Who has the burden of proof on verification at a no-fault trial?

It depends on the issues already established and those remaining for trial. In Right Aid, the Appellate Term followed Island Life and reversed a dismissal that required the provider to proceed before the insurer established the remaining nonreceipt issue. The decision did not place that initial burden on the provider.

What happens if a medical provider never answers a verification request?

A valid, properly maintained verification toll can make an action premature. The insurer still must establish the defense on the relevant record. Separate rules permit denial after more than 120 days for qualifying unanswered requests, subject to the required warning and written reasonable-justification provisions; silence does not prove every request valid.

Can a provider argue the carrier never really mailed the verification requests?

Yes, if mailing remains disputed. In Right Aid, the earlier order had already established timely requests, so that was not the issue left for trial. The order’s actual findings matter as much as the parties’ description of the defense.

Jason’s original commentary

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

This is at most the follow-up to the Travelers case of last week.

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:

• Radiology Today: the requested MRI films were missing.
• Lenox Hill Radiology: MRI reproduction costs and the verification toll.
• South Nassau Orthopedic: the clock after a completed EUO.
• Village Medical Supply: a good reason to request manufacturer invoices.
• Healing Health Products: detailed incoming-mail evidence.
• SS Medical Care: letter copies and an unopposed cross-motion.

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.