Informational guide
NF-10 denial of claim form, explained.
An NF-10 is a New York no-fault denial of claim form. It is often the document that tells the applicant why an insurer denied payment and what may be disputed in arbitration.
Important: This page is general information, not legal, insurance, billing, coding, or medical advice. Check the current AAA, DFS, Arbitration Forums, state, policy, and program rules before filing.
What an NF-10 does
In New York no-fault matters, an insurer may issue an NF-10 denial of claim form to formally deny all or part of a no-fault claim. The denial may identify the claim, parties, amount, date of service, and reason for denial.
DFS says that if an insurer issued a denial applicable to an element of a no-fault claim and the applicant wants to arbitrate the basis of that denial, the applicant can complete the information on the back of the denial and itemize the bills in dispute.
What to check on an NF-10
- Patient or eligible injured person name
- Claim number and policy number
- Provider name
- Dates of service
- Amount billed and amount denied
- Date the denial was issued
- Reason for denial
- Whether the denial covers all bills or selected bills
- Arbitration instructions
- Any referenced verification, IME, EUO, or coverage defense
NF-10 and filing no-fault arbitration
If you use the NF-10 to file, itemize all bills in dispute, attach copies of the listed bills, and include the supporting documents required by the current AAA and DFS instructions. If you do not have an NF-10, DFS points to AAA Form AR1 as the request form.
Official resources
Use official sources for current forms, fees, addresses, deadlines, and filing instructions.
FAQ
Is an NF-10 required to file New York no-fault arbitration?
Not always. DFS says if you are not in receipt of a denial of claim form, you can file by completing AAA Form AR1 and attaching applicable documentation and bills.
What if the NF-10 says to file with DFS?
DFS says arbitration requests must be filed with AAA even if a denial says the request should be filed with DFS.
Should the bills be attached to the NF-10 arbitration request?
DFS says to itemize all bills in dispute and attach copies of all bills listed when arbitrating the basis of a denial.