October 4, 2019
Allstate Ins. Co. v Brown (2019 NY Slip Op 51560(U))
https://www.beynensonlaw.com/case-law/allstate-ins-co-v-brown-2019-ny-slip-op-51560u/
- Decided
- October 4, 2019
- Citation
- 2019 NY Slip Op 51560(U) · 65 Misc 3d 130(A)
- Posture
- Article 75 petition
- Outcome
- Provider prevailed
- Legal questions
- Court review of arbitration awards · No-show defense: insurer's proof (see the maps)
Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.
Summary
Editorial summary by Beynenson Law, not part of the court’s decision.
Reported in New York Official Reports at Allstate Ins. Co. v Brown (2019 NY Slip Op 51560(U))
| Allstate Ins. Co. v Brown |
| 2019 NY Slip Op 51560(U) [65 Misc 3d 130(A)] |
| Decided on October 4, 2019 |
| Appellate Term, First Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Decided on October 4, 2019
PRESENT: Shulman, P.J., Gonzalez, Edmead, JJ.
570204/19
against
Victoria Brown, Defendant-Respondent.
Petitioner appeals from an order and judgment of the Civil Court of the City of New York, New York County (Mary V. Rosado, J.), entered on or about April 26, 2018, which denied its petition to vacate a master arbitration award in favor of respondent and confirmed the award.
Per Curiam.
Order and judgment (Mary V. Rosado, J.), entered on or about April 26, 2018, affirmed, with $25 costs.
Petitioner failed to demonstrate the existence of any of the statutory grounds for vacating the Master Arbitrator’s award (see CPLR 7511[b]). “Since the master arbitrator found that the no-fault arbitrator reached the decision in a rational manner and that the decision was not arbitrary or capricious, incorrect as a matter of law, in excess of policy limits, or in conflict with other no-fault arbitration proceedings there were no grounds for its vacatur; the motion court correctly upheld the master arbitrator’s determination” (Matter of Miller v Elrac, LLC, 170 AD3d 436 [2019], lv denied 33 NY3d 907 [2019]). In particular, since the arbitrator’s rejection of petitioner’s IME no show defense was based, inter alia, upon her review of the proof of mailing the IME notices, the claimant’s appearance at eight prior scheduled IMEs and petitioner’s treatment of claimant as an adversary, the determination was therefore rational, as it was based on the evidence before her (see Matter of Amtrust Group v American Tr. Ins. Co., 161 AD3d 537 [2018]; Park v Long Is. Ins. Co., 13 AD3d 506 [2004]; Empire Mut. Ins. Co. v Hornick, 189 AD2d 707 [1993]).
We note that petitioner does not dispute that the parties agreed, in effect, to bifurcate the arbitration so as to limit the issue before the arbitrator to a determination of the IME no show defense. In the circumstances, petitioner’s complaint that the arbitrator did not resolve other issues is unavailing (see American Intl. Specialty Lines Ins. Co. v Allied Capital Corp., 167 AD3d 142 [2018]).
We have considered petitioner’s remaining arguments and find them unavailing.
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concur I concur I concur
Decision Date: October 04, 2019
Legal questions (2)
Questions of no-fault law this decision rules on, from our Legal Questions pages. Bars count the decisions on the question by year and court, coloured by category; circles are this decision and the decisions on the question it cites or that cite it. Point at a bar or circle for details. The categories and summaries are Beynenson Law’s classification, made by a language model and checked by a second reading.
When does a court vacate, modify or confirm a no-fault arbitrator’s or master arbitrator’s award under CPLR article 75?
This decision: No ground for vacatur or modification shown: the award is confirmed or left in place
Upheld the master arbitrator's award because the arbitrator's rejection of the IME no-show defense rested on her review of the mailing proof and the claimant's prior attendance, and the parties had agreed to limit the issues.
Of the 55 decisions on this question in the First Department courts and the Court of Appeals, 34 (this one included) are in the same category.
Did the insurer prove its IME/EUO no-show defense: mailed, compliant scheduling requests and the claimant’s nonappearance?
This decision: Insurer failed to prove the scheduling letters were mailed or properly addressed (rules on the question, but another ground decided the case)
Left in place, as rational, the arbitrator's rejection of the IME no-show defense based on her review of the mailing proof, the claimant's eight prior appearances, and the insurer's adversarial treatment of the claimant.
Of the 164 decisions on this question in the First Department courts and the Court of Appeals, 13 (this one included) are in the same category. One decision in other departments that cites or is cited by this one is on the full map.
Cited in this decision
A label shows how this decision treated the case it cites.
- Matter of Miller v Elrac, LLC (2019 NY Slip Op 01544) FollowedThe denial of no-fault benefits survived arbitration review because the sworn IME report supplied a rational evidentiary basis.
- Park v Long Is. Ins. Co. (2004 NY Slip Op 09485)The insurer failed to establish a pattern of unreasonable and willful noncooperation warranting denial after the claimant refused an EUO. The injured claimant refused to proceed unless the claimant's spouse could attend, and the insurer denied no-fault benefits for noncooperation.
Similar decisions
- Allstate Ins. Co. v Longevity Med. Supply, Inc. (2018 NY Slip Op 50238(U))A master arbitrator may apply law to established facts and correct legal error even when reaching a conclusion different from the arbitrator's. The insurer sought vacatur under CPLR 7511 of an award of unpaid no-fault benefits and attorney fees.
- Allstate Ins. Co. v Gandron (2019 NY Slip Op 50562(U))The master arbitrator's response to an apparently unsolicited claimant communication did not warrant vacatur for misconduct.
- Allstate Fire & Cas. Ins. Co. v Branch Med., P.C. (2022 NY Slip Op 50277(U))An arbitration award directing payment beyond exhausted no-fault policy limits exceeds the arbitrator's power.
- Allstate Prop. & Cas. Ins. Co. v Northeast Anesthesia & Pain Mgt. (2016 NY Slip Op 50828(U))An arbitration award directing payment beyond a no-fault policy's monetary limit exceeds the arbitrator's power.
- Matter of Allstate Ins. Co. v Westchester Med. Group, M.D. (2015 NY Slip Op 00876)The insurer failed to establish a statutory ground to vacate a master arbitrator's award confirming payment of no-fault benefits.