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David M. Barshay David M. Barshay

If an insurer requires additional verification to process a no-fault claim, it “shall be requested within 15 business days of receipt of the prescribed verification forms.” 11 NYCRR 65-3.5(b). “The insurer is entitled to receive all items necessary to verify the claim directly from the parties from whom such verification was requested.” 11 NYCRR 65-3.5(c). Moreover, “if any requested verifications [sic] has not been supplied to the insurer 30 calendar days after the original request, the insurer shall, within 10 calendar days, follow up with the party from whom the verification was requested, either by telephone call, properly documented in the file, or by mail. At the same time the insurer shall inform the applicant and such person’s attorney of the reason(s) why the claim is delayed by identifying in writing the missing verification and the party from whom it was requested.” 11 NYCRR 65-3.6(b).

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