January 8, 2008
563 Grand Med., P.C. v Progressive Northeastern Ins. Co. (2008 NY Slip Op 50090(U))
https://www.beynensonlaw.com/case-law/563-grand-med-p-c-v-progressive-northeastern-ins-co-2008-ny-slip-op50090u/
- Decided
- January 8, 2008
- Citation
- 2008 NY Slip Op 50090(U) · 18 Misc 3d 132(A)
- Posture
- Article 75 petition
- Outcome
- Insurer prevailed
- Legal questions
- Court review of arbitration awards (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 563 Grand Med., P.C. v Progressive Northeastern Ins. Co. (2008 NY Slip Op 50090(U))
| 563 Grand Med., P.C. v Progressive Northeastern Ins. Co. |
| 2008 NY Slip Op 50090(U) [18 Misc 3d 132(A)] |
| Decided on January 8, 2008 |
| Appellate Term, Second 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
SUPREME COURT OF THE STATE OF NEW YORK
APPELLATE TERM: 2nd and 11th JUDICIAL DISTRICTS
PRESENT: : WESTON PATTERSON, J.P., GOLIA and BELEN, JJ
2006-1100 K C.
against
Progressive Northeastern Ins. Co., Respondent.
Appeal from a judgment of the Civil Court of the City of New York, Kings County (Bernard J. Graham, J.), entered January 19, 2006. The judgment denied the petition to vacate a master arbitrator’s award.
Judgment modified by adding thereto a provision confirming the master arbitrator’s award; as so modified, affirmed without costs.
563 Grand Medical, P.C. commenced this proceeding pursuant to CPLR 7511 to vacate a master arbitrator’s award which denied its claims for assigned first-party no-fault benefits. After respondent opposed the petition, the court denied the petition. This appeal by petitioner ensued.
An arbitrator in an arbitration proceeding to recover no-fault benefits may raise any issue which the arbitrator deems relevant (see Insurance Department Regulations [11 NYCRR] § 65-4.4 [e]; § 65-4.5 [o]; see also Matter of Medical Socy. of State of N.Y. v Serio, 100 NY2d 854, 872 [2003]; 563 Grand Med., P.C. v New York State Ins. Dept., 24 AD3d 413 [2005]; cf. Matter of Health & Endurance Med., P.C. v Deerbrook Ins. Co., 44 AD3d 857 [2007]). The master arbitrator determined that, based upon the documents submitted to the arbitrator, the arbitrator had a rational basis for finding that petitioner was not entitled to recover because, among other things, petitioner may have been seeking to recover for work performed by an independent contractor. In our view, the master arbitrator’s determination was not arbitrary, capricious or irrational (see Matter of Petrofsky [Allstate Ins. Co.], 54 NY2d 207 [1981]). Accordingly, the court below properly denied the petition to vacate the master arbitrator’s award. However, upon denying the petition, the court was required, pursuant to CPLR 7511 (e), to confirm the award (see Matter of Exclusive Med. & Diagnostic v Government Empls. Ins. Co., 306 AD2d 476 [*2][2003]).
Weston Patterson, J.P., Golia and Belen, JJ., concur.
Decision Date: January 8, 2008
Legal questions
A question 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
Held the master arbitrator's determination not irrational because the arbitrator may raise any relevant issue and rationally found the provider might be billing for an independent contractor's work, so the award was confirmed.
Of the 119 decisions on this question in the Second Department courts and the Court of Appeals, 92 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- 563 Grand Med., P.C. v New York State Ins. Dept. (2005 NY Slip Op 09274)An arbitrator's authority under 11 NYCRR 65-4.5 (o) (1) to raise relevant issues independently does not violate procedural due process.
- Matter of Health & Endurance Med., P.C. v Deerbrook Ins. Co. (2007 NY Slip Op 07844) Contrasted (cf., but see)An arbitrator impermissibly raised provider eligibility sua sponte when the insurer disputed only the need for the services.
Similar decisions
- 563 Grand Med., P.C. v State-Wide Ins. Co. (2007 NY Slip Op 50362(U))Denial of a petition to vacate a master arbitrator's award requires confirmation of the award under CPLR 7511 (e).
- 563 Grand Med., P.C. v Nationwide Ins. Co. (2009 NY Slip Op 51493(U))The provider's arbitration-vacatur petition failed because its sole supporting document was not affirmed under penalties of perjury.
- 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.
- SP Med., P.C. v General Assur. Co. (2007 NY Slip Op 52452(U))The provider's petition to vacate the master arbitrator's award was denied because the record supplied a rational basis for the award.
- Avenue N Med., P.C. v New York Cent. Mut. Fire Ins. Co. (2006 NY Slip Op 52549(U))Denial of a petition to vacate a master arbitrator's award requires confirmation of the award under CPLR 7511 (e).