December 12, 2019

Matter of Global Liberty Ins. Co. of N.Y. v North Shore Family Chiropractic, PC (2019 NY Slip Op 08951)

https://www.beynensonlaw.com/case-law/matter-of-global-liberty-ins-co-of-n-y-v-north-shore-family-chiropractic-pc-2019ny-slip-op-08951/

Court: Appellate Division, First Department
Decided: December 12, 2019
Citation: 2019 NY Slip Op 08951 · 178 AD3d 525
Posture: Article 75 petition
Outcome: Provider prevailed
Later treatment: Followed in 1 later decision (see Cited by)
Issues: Priority, other coverage CPLR article 75 (arbitration awards) Interest and attorney fees

Cite as

Matter of Global Liberty Ins. Co. of N.Y. v North Shore Family Chiropractic, PC, 178 AD3d 525 (1st Dept 2019)

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.

The insurer failed to establish that the assignor was injured in the course of employment and eligible for workers' compensation. Although the assignor allegedly was injured driving a livery car, the Taxi and Limousine Commission license was issued that day, and the insurer offered no evidence that the assignor was on duty or carrying a paying passenger. The Appellate Division, First Department, affirmed dismissal of the insurer's petition to vacate the arbitration award and modified the order to remand for determination of the providers' attorney fees. Under 11 NYCRR 65-4.10 (j) (4), Supreme Court could award fees for judicial review of a master arbitration award and further appeals, including this appeal; it had failed to address the providers' request.

Reported in New York Official Reports at Matter of Global Liberty Ins. Co. of N.Y. v North Shore Family Chiropractic, PC (2019 NY Slip Op 08951)

Matter of Global Liberty Ins. Co. of N.Y. v North Shore Family Chiropractic, PC

2019 NY Slip Op 08951 [178 AD3d 525]

December 12, 2019

Appellate Division, First Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

As corrected through Wednesday, January 29, 2020

[*1]

In the Matter of Global Liberty Insurance Company of New York, Appellant-Respondent,
v
North Shore Family Chiropractic, PC, as Assignee of Ramon Martinez, et al., Respondents-Appellants.

The Law Office of Jason Tenenbaum, P.C., Garden City (Talia Beard of counsel), for appellant-respondent.

Gary Tsirelman, P.C., Brooklyn (Gary Tsirelman of counsel), for respondents-appellants.

Order, Supreme Court, Bronx County (Donna Mills, J.), entered February 1, 2019, which granted respondents’ motion to vacate, pursuant to stipulation, an order entered on default vacating an arbitration award, deny the petition to vacate the award, and grant statutory attorneys’ fees, to the extent of dismissing the petition, unanimously modified, on the law, to remand for a determination of respondents’ attorneys’ fees pursuant to 11 NYCRR 65-4.10 (j) (4), and otherwise affirmed, without costs.

Petitioner failed to establish that respondents’ assignor was injured in the course of his employment, and therefore that it properly denied his claim because workers’ compensation benefits were available to him (see Westchester Med. Ctr. v American Tr. Ins. Co., 60 AD3d 848, 849 [2d Dept 2009]). Although the assignor was allegedly injured while driving a livery car, his license from the New York Taxi and Limousine Commission was issued that day. Further, petitioner submitted no evidence that the assignor was on duty or carrying a paying passenger at the time of the incident (cf. Matter of Aminov v New York Black Car Operators Injury Compensation Fund, 2 AD3d 1007, 1007-1008 [3d Dept 2003], lv denied 4 NY3d 709 [2005]).

Supreme Court had the authority to award attorneys’ fees in connection with a “court appeal from a master arbitration award and any further appeals” (11 NYCRR 65-4.10 [j] [4]). Because the court failed to address respondents’ request for attorneys’ fees, the matter is remanded for a determination of the amount of fees to which respondents are entitled (see Matter of GEICO Ins. Co. v AAAMG Leasing Corp., 148 AD3d 703 [2d Dept 2017]), including fees for the instant appeal (see Matter of Country-Wide Ins. Co. v Bay Needle Acupuncture, P.C., 167 AD3d 404, 405 [1st Dept 2018]). Concur—Richter, J.P., Manzanet-Daniels, Webber, Gesmer, JJ.

Cited in this decision

A label shows how this decision treated the case it cites.

Westchester Med. Ctr. v American Tr. Ins. Co. (2009 NY Slip Op 01979) FollowedThe insurer's timely verification request and ensuing timely denial defeated the provider's motion for summary judgment.
Matter of GEICO Ins. Co. v AAAMG Leasing Corp. (2017 NY Slip Op 01552) FollowedA provider may recover an additional attorney's fee for an article 75 proceeding to confirm or vacate a master arbitration award.
Matter of Country-Wide Ins. Co. v Bay Needle Acupuncture, P.C. (2018 NY Slip Op 08238) FollowedThe insurer's billing-fraud evidence did not establish a Mallela defense exempt from the 30-day denial deadline.

Cited by

A label shows how the later decision treated this one.

American Tr. Ins. Co. v North Shore Family Chiropractic PC (2023 NY Slip Op 50208(U)) FollowedThe insurer's police report did not require referral of its course-of-employment defense to the Workers' Compensation Board.
American Tr. Ins. Co. v Rutland Med., PC (2023 NY Slip Op 50814(U))A no-fault arbitrator need not require a formal rebuttal specifically addressing an insurer's peer review or IME report.
Quick v State Farm Mut. Auto. Ins. Co. (2024 NY Slip Op 06268)Workers' compensation remains primary to no-fault benefits even when the employer lacks workers' compensation insurance.
American Tr. Ins. Co. v Nexray Med. Imaging PC (2023 NY Slip Op 50506(U))The insurer's challenge to the arbitrator's finding of insufficient causation evidence raised a factual issue, not an error of law.
American Tr. Ins. Co. v Nexray Med. Imaging PC (2023 NY Slip Op50538(U))A Workers' Compensation Board rejection does not restart the insurer's 30-day period to deny a claim for lack of medical necessity.
American Tr. Ins. Co. v Nexray Med. Imaging PC (2023 NY Slip Op 50953(U))The insurer's petition to vacate a master arbitration award was denied because it submitted an award from a different arbitration.

Similar decisions

Matter of Global Liberty Ins. Co. v Professional Chiropractic Care, P.C. (2016 NY Slip Op 04156)A master arbitrator's award was irrational because it ignored the coverage effect of the assignor's failure to attend duly scheduled IMEs. The insurer presented authority establishing that the IME nonappearances rendered the no-fault policy void ab initio.
Matter of Global Liberty Ins. Co. of N.Y. v Avangard Supply, Inc. (2020 NY Slip Op 06855)An insurer's vague IME-based denial supported a rational arbitration award of no-fault benefits to the providers.
Matter of Country-Wide Ins. Co. v TC Acupuncture P.C. (2019 NY Slip Op 04087)Attorney fees for judicial review of a master arbitration award are fixed by the court under 11 NYCRR 65-4.10 (j) (4).
Matter of American Tr. Ins. Co. v Comfort Choice Chiropractic, P.C. (2025 NY Slip Op 01363)The provider was entitled to attorney's fees after defeating the insurer's petition to vacate its arbitration award.
Matter of Global Liberty Ins. Co. v Coastal Anesthesia Servs., LLC (2016 NY Slip Op 08964)A no-fault arbitrator has discretion to refuse late submissions under 11 NYCRR 65-4.2 (b) (3).