July 8, 2026

Matter of 563 Grand Med., P.C. v Country-Wide Ins. Co. (2026 NY Slip Op 04293)

Headnote

The provider's additional attorney's fee motion failed because no valid denied or overdue claim had been determined when it moved. Supreme Court had vacated a master arbitration award rejecting the claims for failure to prove standing and referred them to arbitration for further proceedings. That ruling did not establish entitlement to payment. Insurance Law § 5106 (a) and 11 NYCRR 65-4.10 (j) (4) permit fees for securing payment of a valid claim that was denied or overdue. The Appellate Division, Second Department, reversed the money judgment awarding additional fees and denied the provider's motion. It dismissed the separate appeal from the order because the money judgment superseded it.

Reported in New York Official Reports at Matter of 563 Grand Med., P.C. v Country-Wide Ins. Co. (2026 NY Slip Op 04293)

Matter of 563 Grand Med., P.C. v Country-Wide Ins. Co.
2026 NY Slip Op 04293 [251 AD3d 681]
Decided on July 8, 2026
Appellate Division, Second Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, September 9, 2026


In the Matter of 563 Grand Medical, P.C., as Assignee of Raymond Martinez, Respondent,

v

Country-Wide Ins. Co., Appellant.

Insurance — No-Fault Automobile Insurance — Claim Overdue or Denied — Entitlement to Attorneys’ Fees

Jaffe & Velazquez, LLP (Thomas Torto, New York, NY, of counsel), for appellant.

Gary Tsirelman, P.C., Brooklyn, NY (Stefan Belinfanti of counsel), for respondent.

In a proceeding pursuant to CPLR article 75, inter alia, to vacate a master arbitration award dated February 18, 2020, Country-Wide Ins. Co. appeals from (1) an order of the Supreme Court, Kings County (Lillian Wan, J.), dated November 10, 2021, and (2) a money judgment of the same court dated November 15, 2023. The order granted the motion of 563 Grand Medical, P.C., for an award of additional attorneys’ fees pursuant to 11 NYCRR 65-4.10 (j) (4). The money judgment, upon the order, awarded 563 Grand Medical, P.C., additional attorneys’ fees in the sum of $1,950, plus costs and disbursements.

Ordered that the appeal from the order is dismissed; and it is further,

Ordered that the money judgment is reversed, on the law, the motion of 563 Grand Medical, P.C., for an award of additional attorneys’ fees pursuant to 11 NYCRR 65-4.10 (j) (4) is denied, and the order is modified accordingly; and it is further,

Ordered that one bill of costs is awarded to the appellant.

The appeal from the order must be dismissed because the order was superseded by the money judgment dated November 15, 2023 (see Burns v Burns, 229 AD3d 675, 676 [2024]; Christopulos v Christopulos, 209 AD3d 970 [2022]). The issues raised on the appeal from the order are brought up for review and have been considered on the appeal from the money judgment (see Burns v Burns, 229 AD3d at 676).

563 Grand Medical, P.C. (hereinafter Grand Medical), commenced this proceeding pursuant to CPLR article 75, inter alia, to vacate a master arbitration award dated February 18, 2020, which affirmed an arbitration award that had denied Grand Medical’s claims against Country-Wide Ins. Co. (hereinafter Country-Wide) for no-fault insurance benefits. In an order dated December 21, 2020, the Supreme Court, among other things, granted that branch of the petition which was to vacate the master arbitration award, denied Country-Wide’s cross-petition to confirm the master arbitration award, and referred the matter to arbitration for further proceedings.

Grand Medical moved for an award of additional attorneys’ fees pursuant to 11 [*2]NYCRR 65-4.10 (j) (4). In an order dated November 10, 2021, the Supreme Court granted the motion, and a money judgment dated November 15, 2023, was issued awarding Grand Medical additional attorneys’ fees in the sum of $1,950, plus costs and disbursements. Country-Wide appeals.

Insurance Law § 5106 (a) provides: “If a valid claim or portion was overdue, the claimant shall also be entitled to recover his attorney’s reasonable fee, for services necessarily performed in connection with securing payment of the overdue claim, subject to limitations promulgated by the superintendent in regulations.” The relevant regulation providing such “[l]imitations on attorneys’ fees pursuant to section 5106 of the Insurance Law,” specifies that “[t]he attorneys’ fee for services rendered . . . in a court appeal from a master arbitration award and any further appeals, shall be fixed by the court adjudicating the matter” (11 NYCRR 65-4.10 [j] [4]).

Thus, under the statute and its implementing regulation, “a claimant is entitled to recover attorney’s fees where a ‘valid claim or portion’ was denied or overdue” (Presbyterian Hosp. in City of N.Y. v Maryland Cas. Co., 90 NY2d 274, 278 [1997], quoting Insurance Law § 5106 [a]). Here, however, at the time that Grand Medical moved for an award of additional attorneys’ fees pursuant to 11 NYCRR 65-4.10 (j) (4), no determination had been made that Grand Medical had a valid claim that was denied or overdue (cf. Matter of American Tr. Ins. Co. v Comfort Choice Chiropractic, P.C., 236 AD3d 782, 782-783 [2025]; Acuhealth Acupuncture, P.C. v Country-Wide Ins. Co., 170 AD3d 1168 [2019]; Matter of GEICO Ins. Co. v AAAMG Leasing Corp., 148 AD3d 703, 704-706 [2017]). Rather, the Supreme Court had merely decided that the claims should not have been denied for failure to prove standing and the matter was referred to arbitration for further proceedings on Grand Medical’s claims for no-fault insurance benefits. Under those circumstances, Grand Medical did not demonstrate its entitlement to an award of additional attorneys’ fees pursuant to 11 NYCRR 65-4.10 (j) (4) (see Matter of Fast Care Med. Diagnostics, PLLC/PV v Government Empls. Ins. Co., 161 AD3d 1149, 1151 [2018]; see also Matter of Bay Needle Care Acupuncture, P.C. v Country Wide Ins. Co., 176 AD3d 695, 696 [2019]).

Accordingly, we reverse the money judgment and deny Grand Medical’s motion for an award of additional attorneys’ fees pursuant to 11 NYCRR 65-4.10 (j) (4).

Grand Medical’s remaining contention is without merit. Iannacci, J.P., Wooten, Dowling and McCormack, JJ., concur.