February 4, 2015
Matter of Allstate Ins. Co. v Westchester Med. Group, M.D. (2015 NY Slip Op 00876)
https://www.beynensonlaw.com/case-law/matter-of-allstate-ins-co-v-westchester-med-group-m-d-2015-ny-slip-op00876/
- Decided
- February 4, 2015
- Citation
- 2015 NY Slip Op 00876 · 125 AD3d 649
- Posture
- Article 75 petition
- Outcome
- Provider prevailed
- Later treatment
- Followed in 1 later decision (see Cited by)
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 Matter of Allstate Ins. Co. v Westchester Med. Group, M.D. (2015 NY Slip Op 00876)
| Matter of Allstate Ins. Co. v Westchester Med. Group, M.D. |
| 2015 NY Slip Op 00876 [125 AD3d 649] |
| February 4, 2015 |
| Appellate Division, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| In the Matter of Allstate Insurance Company,
Appellant, v Westchester Medical Group, M.D., as Assignee of Carmen Carvajal, Respondent. |
Peter C. Merani, P.C., New York, N.Y. (Mark J. Fenelon and Eric Wahrburg of counsel), for appellant.
Subin Associates, LLP, New York, N.Y. (Gregory T. Cerchione and Asya Domashitsky of counsel), for respondent.
In a proceeding pursuant to CPLR article 75 to vacate an award of a master arbitrator dated July 23, 2012, confirming an award of an arbitrator dated April 5, 2012, the petitioner appeals from an order of the Supreme Court, Nassau County (Phelan, J.), entered March 18, 2013, which denied the petition and confirmed the master arbitrator’s award.
Ordered that the order is affirmed, with costs.
In this case, the nonparty, Carmen Carvajal, allegedly was injured in a motor vehicle accident on February 22, 2011, and thereafter sought treatment from the Westchester Medical Group, incorrectly named herein as Westchester Medical Group, M.D. (hereinafter Westchester). As assignee of Carvajal, Westchester sought from her insurance carrier, the petitioner Allstate Insurance Company (hereinafter Allstate), no-fault benefits in the sum of $352.81 for medical services rendered to Carvajal. However, Allstate maintained that it had no duty to pay this sum since its request to Westchester for “additional verification” allegedly remained outstanding (see 11 NYCRR 65-3.5 [f]). In an award dated April 25, 2012, the arbitrator concluded that Westchester did in fact comply with the requests for additional verification, and that Allstate “did not appear to be acting in good faith.” That award was confirmed in an award issued by a master arbitrator on July 23, 2012. The Supreme Court denied Allstate’s petition to vacate the master arbitrator’s award and confirmed the award. We affirm.
“Consistent with the public policy in favor of arbitration, the grounds specified in CPLR 7511 for vacating or modifying a no-fault arbitration award are few in number and narrowly applied” (Matter of Mercury Cas. Co. v Healthmakers Med. Group, P.C., 67 AD3d 1017, 1017 [2009]; see Matter of Green v Liberty Mut. Ins. Co., 22 AD3d 755, 755-756 [2005]; Matter of Domotor v State Farm Mut. Ins. Co., 9 AD3d 367 [2004]). Here, Allstate failed to demonstrate the existence of any of the statutory grounds for vacating the master arbitrator’s award. In addition, the determination of the master arbitrator confirming the original arbitration award had evidentiary support and a rational basis (see Matter of Smith [Firemen’s Ins. Co.], 55 NY2d 224, 231-232 [1982]; Matter of Petrofsky [Allstate Ins. Co.], 54 [*2]NY2d 207, 211 [1981]; Matter of Fireman’s Fund Ins. Co. v Allstate Ins. Co., 46 AD3d 560, 561 [2007]). “It is not for [the court] to decide whether [the master] arbitrator erred [in applying the applicable law]” (Matter of Falzone [New York Cent. Mut. Fire Ins. Co.], 15 NY3d 530, 535 [2010]). Accordingly, the Supreme Court properly denied the petition and confirmed the award. Mastro, J.P., Roman, Sgroi and Barros, JJ., concur.
Cited in this decision
A label shows how this decision treated the case it cites.
- Matter of Mercury Cas. Co. v Healthmakers Med. Group, P.C. (2009 NY Slip Op 08826)A court denying vacatur or modification of a no-fault arbitration award must confirm the award under CPLR 7511 (e).
- Matter of Green v Liberty Mut. Ins. Co. (2005 NY Slip Op 07961)An arbitrator acted within discretionary authority in refusing late submissions from both parties to a no-fault arbitration.
- Matter of Fireman’s Fund Ins. Co. v Allstate Ins. Co. (2007 NY Slip Op 09590)An arbitrator's refusal to consider an insurer's coverage defense in an unexplained, untimely answer was not arbitrary and capricious.
- Matter of Falzone (New York Cent. Mut. Fire Ins. Co.) (2010 NY Slip Op 07417) FollowedAn arbitrator's failure to apply collateral estoppel does not alone permit vacatur of an award under CPLR 7511 (b) (1) (iii).
Cited by
A label shows how the later decision treated this one.
- Matter of American Tr. Ins. Co. v Atlantic Med. Care, P.C. (2025 NY Slip Op 07297) FollowedA master arbitrator's legal error does not warrant vacatur unless the determination is irrational.
- Matter of Acuhealth Acupuncture, P.C. v New York City Tr. Auth. (2018 NY Slip Op 08641)The master arbitrator's confirmation of an award denying benefits for exhausted policy limits had evidentiary support and a rational basis.
- Matter of Singh v Allstate Ins. Co. (2016 NY Slip Op 01855)The injured claimant's petition to vacate four master arbitration awards denying lost-wage benefits was denied for lack of a vacatur ground.
- Matter of American Tr. Ins. Co. v Big Apple Pain Mgt., PLLC (2025 NY Slip Op 05948)The insurer's petition to vacate a master arbitrator's award was denied because it failed to establish statutory grounds for vacatur.
- ENS Med., P.C. v Nationwide Ins. Co. (2026 NY Slip Op 26033)A provider may arbitrate a claim for lost earnings incurred in attending an insurer-demanded EUO. Insurance Law § 5106 (b) encompasses reimbursement disputes arising from claim verification, and 11 NYCRR 65-3.5 (e) requires reimbursement.
- Matter of Nostrand Drugs Rx, Inc. v Church Mut. Ins. Co. (2026 NY Slip Op 05400)The provider's petition to vacate a master arbitration award was denied because it showed no statutory ground for vacatur.
- Matter of Fill Rx NY, Inc. v LM Gen. Ins. Co. (2025 NY Slip Op 04785)The provider's petition to vacate a master arbitration award upholding the insurer's policy-exhaustion defense was denied.
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.
- L.I. Community Med., P.C. v Allstate Ins. Co. (2008 NY Slip Op 51034(U))A master arbitrator's award had a rational basis where the provider's assignment named a different entity and did not establish standing.
- S.P. Med. Ctr. v Allstate Ins. Co. (2007 NY Slip Op 51978(U))An award must be confirmed under CPLR 7511 (e) when a petition to vacate it is denied.
- Matter of Travelers Indem. Co. v United Diagnostic Imaging, P.C. (2010 NY Slip Op 01658)The insurer failed to establish grounds to vacate a master arbitration award that had evidentiary support and a rational basis.
- 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.