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Additional Verification

92 articles by Jason Tenenbaum, Esq.

120-day rule and Fee Schedule

New York court ruling demonstrates how healthcare providers can lose no-fault claims due to verification failures and fee schedule violations in insurance disputes.

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Untimely second letter

Court ruling clarifies timing requirements for second EUO scheduling letters in no-fault insurance cases, emphasizing strict compliance with regulatory deadlines.

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The 120-day rule

Learn NY no-fault insurance 150-day verification rule. Expert analysis of Chapa decision & claim timing requirements. Call 516-750-0595.

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Another Verification

Learn about no-fault insurance verification requirements in New York. Expert analysis of Orthoplus decision and compliance strategies. Call 516-750-0595.

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Verification, again

New Horizon Surgical case analysis: Court dismisses no-fault claim when plaintiff's affidavit failed to include requested informed consent form despite claiming full compliance.

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120-day rule rebutted

Court ruling shows affidavit alone can create triable issue on verification receipt despite 120-day rule, prompting questions about documentary evidence standards.

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120-day rule crumbles

Court case analysis showing how the 120-day rule for no-fault insurance verification demands has been weakened, allowing claims to proceed despite procedural issues.

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No need to send letter to attorney

Court clarifies delay letter requirements under 11 NYCRR 65-3.6(b), ruling insurers only must notify attorneys when seeking verification from third parties, not plaintiffs.

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Verification issues

Analysis of Atlantic Radiology v Travelers case addressing verification request failures and timing issues in NY no-fault insurance claims litigation.

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The By-Report

Analysis of Bronx Acupuncture v Hereford case clarifying that by-report codes are verification issues, not automatic denials in NY no-fault insurance claims.

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The verifications were not mailed

A no-fault insurance case where inadequate affidavits led to defeat, highlighting the importance of learning from legal mistakes and improving documentation strategies.

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EUO & IME no show

Court denies plaintiff's motion in no-fault case due to failed verification compliance and assignor's failure to appear for required IMEs and EUOs.

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Allowing non-sense to continue

Court allows bare "I responded to verification" affidavit to defeat summary judgment motion, despite no actual verification documents being submitted as evidence.

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Non receipt and verification

Court ruling on non-receipt denials and verification requirements in NY no-fault insurance claims, including burden of proof standards for medical providers.

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Verification defense upheld

NY court upholds verification defense in no-fault insurance case, ruling defendant need not prove verification letters weren't tampered with per Schozer precedent.

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Verification

Court ruling on verification request mailing requirements in NY no-fault insurance claims, establishing that delivery to USPS completes the request process.

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A triable issue of fact

Court ruling shows defendant raised triable issue of fact on 30-day denial period through additional verification timing, shifting burden from carriers.

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Follow the NF-5

Mount Sinai v Dust Tr. case analysis: verification requests sent before receiving NF-5 forms don't toll the 30-day payment period under NY no-fault law.

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Additional verification issue

NY Appellate Term reverses summary judgment in medical provider case, finding triable issues of fact regarding whether additional verification requests were properly responded to.

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First Application of Etienne

Westchester Med. Ctr. v Allstate case analysis: prima facie requirements under Etienne standard vs. Mary Immaculate precedent in NY no-fault claims.

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Additional Verification

New York court ruling clarifies that insurance delay letters must request specific verification to toll statutory payment deadlines, raising questions about required detail levels.

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IME no show and tolling

NY appellate court clarifies IME no-show denial timing rules when verification requests toll insurance company's response deadlines under no-fault law.

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Another verification again

New York court ruling demonstrates how insurance companies can successfully defend no-fault claims when healthcare providers fail to respond to verification requests.

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My AIG bail out money at work

AIG's failure to properly handle no-fault claim denials highlights insurance company obligations under New York's strict 30-day statutory period requirements.

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on file"

Learn about NY signature on file requirements for assignment of benefits forms. Expert analysis of verification procedures and no-fault insurance law.

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