March 21, 2019
Matter of Global Liberty Ins. Co. v Medco Tech, Inc. (2019 NY Slip Op 02167)
https://www.beynensonlaw.com/case-law/matter-of-global-liberty-ins-co-v-medco-tech-inc-2019-ny-slip-op02167/
- Decided
- March 21, 2019
- Citation
- 2019 NY Slip Op 02167 · 170 AD3d 558
- Posture
- Article 75 petition
- Outcome
- Insurer prevailed
- Later treatment
- Contrasted (cf., but see) in 1 later decision (see Cited by)
- 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 Matter of Global Liberty Ins. Co. v Medco Tech, Inc. (2019 NY Slip Op 02167)
| Matter of Global Liberty Ins. Co. v Medco Tech, Inc. |
| 2019 NY Slip Op 02167 [170 AD3d 558] |
| March 21, 2019 |
| Appellate Division, First Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| In the Matter of Global Liberty Insurance Company,
Appellant, v Medco Tech, Inc., as Assignee of Coreen Josiah, Respondent. |
Law Office of Jason Tenenbaum, P.C., Garden City (Jason Tenenbaum of counsel), for appellant.
Israel, Israel & Purdy, LLP, Great Neck (William M. Purdy of counsel), for respondent.
Judgment, Supreme Court, Bronx County (Julia I. Rodriguez, J.), entered August 29, 2016, against petitioner in favor of respondent, and bringing up for review an order, same court and Justice, entered January 12, 2016, which denied petitioner’s motion to vacate an arbitral award and remand to the lower arbitrator for a de novo hearing, and granted respondent’s motion to confirm the award, unanimously reversed, on the law, without costs, the judgment vacated, petitioner’s motion granted, and respondent’s motion denied.
Respondent seeks from petitioner no-fault insurance benefits for medical equipment that respondent provided to its assignor, who was involved in a motor vehicle accident. In denying respondent’s claim, petitioner relied on a peer review report that concluded, based on a review of the medical records, that the assignor’s condition was degenerative in nature and not post-traumatic and therefore that the surgery undergone by the assignor was “not medically necessary in relation to the accident” (emphasis supplied). The arbitral award must be vacated and a de novo hearing held, because, on the record before us, as argued, it would be irrational to conclude that the need for the subject medical equipment was causally related to the accident (see Matter of Smith [Firemen’s Ins. Co.], 55 NY2d 224, 232 [1982]; Mount Sinai Hosp. v Triboro Coach, 263 AD2d 11, 18-19 [2d Dept 1999]; Shahid Mian, M.D., P.C. v Interboro Ins. Co., 39 Misc 3d 135[A], 2013 NY Slip Op 50589[U] [App Term, 1st Dept 2013]). Concur—Friedman, J.P., Renwick, Webber, Kahn, Kern, JJ.
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: Award vacated or modified because it was irrational, arbitrary and capricious, without evidentiary support or contrary to settled law
Vacated the award and ordered a de novo hearing because, on the record, it was irrational to find the equipment causally related to the accident when the peer review attributed the condition to degeneration.
Of the 55 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
- Shahid Mian, M.D., P.C. v Interboro Ins. Co. (2013 NY Slip Op 50589(U))The insurer established that the treated condition was unrelated to the accident, and the provider failed to raise a triable issue.
Cited by
A label shows how the later decision treated this one.
- American Tr. Ins. Co. v U.S. Med Supply Corp. (2023 NY Slip Op 50560(U)) Contrasted (cf., but see)A provider invoking collateral estoppel from a prior no-fault award need not prove master arbitrator affirmance or judicial confirmation.
- Matter of Hereford Ins. Co. v Corona Med. PC (2021 NY Slip Op 50991(U))A no-fault arbitration award against the insurer was vacated because its policy did not cover the assignor's rental vehicle.
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 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).
- Matter of Global Liberty Ins. Co. v Lenox Hill Radiology & Med. Imaging Assoc. P.C. (2016 NY Slip Op 51792(U))The insurer's petition to vacate a master arbitration award upholding the provider's reimbursement claim was denied.
- Matter of Global Liberty Ins. Co. of N.Y. v Capital Chiropractic, P.C. (2020 NY Slip Op 01466)The master arbitrator's award was arbitrary because it ignored precedent treating IME nonappearance as voiding the policy from inception.