Same But Different -- No-Fault Insurer's Right To Require Submission of NF-3

NO-FAULT – PRESCRIBED NF-3 VERIFICATION FORM – OTHER FORM WITH SUBSTANTIALLY SAME INFORMATION
All-Boro Med. Supplies, Inc. v. Progressive Northeastern Ins. Co.
(NYC Civil, Kings Co., decided 4/15/2008)

Under Regulation 68, although a no-fault insurer "must accept" proof of claim on a form other than a prescribed form if it contains substantially the same information as the prescribed form (such as a HCFA 1500 form), it "may require" the submission of the prescribed NF-3 verification form. So says 11 NYCRR § 65-3.5(f) , read strictly, as so says Judge Noach Dear of the NYS Civil Court for Kings County. In this case, the Judge Dear found that "may require" was not mutually exclusive of "must accept", provided the no-fault insurer makes a timely additional verification request and follow-up request for the prescribed NF-3 form, which the provider conceded Progressive had done in this case. Without submission of the NF-3, the claims did not become "due". Judgment, therefore, for Progressive dismissing the complaint as premature.