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May 23, 2005

Matter of State Farm Mut. Auto. Ins. Co. v Lumbermens Mut. Cas. Co. (2005 NY Slip Op 04234)

https://www.beynensonlaw.com/case-law/matter-of-state-farm-mut-auto-ins-co-v-lumbermens-mut-cas-co-2005-ny-slip-op-04234/

Court
Appellate Division, Second Department
Decided
May 23, 2005
Citation
2005 NY Slip Op 04234 · 18 AD3d 762
Posture
Article 75 petition
Later treatment
Followed in 7 later decisions (see Cited by)
Issues
CPLR article 75 (arbitration awards) Priority, other coverage
Cite as
Matter of State Farm Mut. Auto. Ins. Co. v Lumbermens Mut. Cas. Co., 18 AD3d 762 (2d Dept 2005)

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.

An interinsurer priority-of-payment award survived vacatur because it had a reasonable basis in the failure to prove another driver's negligence. The petitioning insurer challenged an award assigning it full responsibility for first-party benefits, arguing that physical contact with the pedestrian was an improper sole basis in the priority dispute under Insurance Law § 5105 (b). The Appellate Division, Second Department, affirmed denial of the CPLR article 75 petition. The award could rest on the absence of proof that the other insurer's driver was negligent. Even assuming legal error, a reasonable hypothesis supported the award, which did not contradict settled law and was not subject to vacatur under CPLR 7511 (b) (1).

Reported in New York Official Reports at Matter of State Farm Mut. Auto. Ins. Co. v Lumbermens Mut. Cas. Co. (2005 NY Slip Op 04234)

Matter of State Farm Mut. Auto. Ins. Co. v Lumbermens Mut. Cas. Co.
2005 NY Slip Op 04234 [18 AD3d 762]
May 23, 2005
Appellate Division, Second Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, July 20, 2005
In the Matter of State Farm Mutual Automobile Insurance Company, Appellant,
v
Lumbermens Mutual Casualty Co., Respondent.

—[*1]

In a proceeding pursuant to CPLR article 75 to vacate an arbitrator’s award, the petitioner appeals from a judgment of the Supreme Court, Queens County (Rios, J.), dated July 16, 2004, which denied the petition and dismissed the proceeding.

Ordered that the judgment is affirmed, with costs.

The appellant, State Farm Mutual Automobile Insurance Company (hereinafter State Farm), argues that, in this “priority of payments” dispute, the arbitrator erred in concluding that State Farm was 100% liable for the payment of first-party benefits solely on the basis that State Farm’s insured vehicle was the only vehicle that actually made physical contact with the injured pedestrian (see Insurance Law § 5105 [b]; 11 NYCRR 65-3.12 [e]; 65-3.14 [b] [3]; 65.15 [m] [2] [iii]; Matter of Pacific Ins. Co. v State Farm Mut. Auto. Ins. Co., 150 AD2d 455 [1989]). In opposition, Lumbermens Mutual Casualty Company (hereinafter Lumbermens) argues that the arbitrator’s award was proper in light of the absence of any competent evidence that would tend to prove that the negligence of its insured driver, whose car did not make any physical contact with the injured pedestrian, was in some way at fault in connection with the occurrence. [*2]

We agree with Lumbermens that the award could properly have been based on State Farm’s failure to prove any negligence on the part of Lumbermens’ insured driver. Also, even assuming that the arbitrator might have misapplied applicable law as argued by State Farm, the arbitrator’s award was at least supported by a “reasonable hypothesis” and was not contrary to what could be fairly described as settled law (Matter of Motor Veh. Acc. Indem. Corp. v Aetna Cas. & Sur. Co., 89 NY2d 214, 224 [1996]; see Matter of Smith [Firemen’s Ins. Co.], 55 NY2d 224, 231 [1982]; Matter of Hegarty v Board of Educ. of City of N.Y., 5 AD3d 771 [2004]; Matter of Hanover Ins. Co. v State Farm Mut. Auto. Ins. Co., 226 AD2d 533 [1996]; Matter of Adams v Allstate Ins. Co., 210 AD2d 319 [1994]; Matter of Shand, 74 AD2d 442, 454 [1980]). Thus, the arbitrator’s award was not subject to vacatur under CPLR 7511 (b) (1). Prudenti, P.J., Schmidt, Luciano and Lifson, JJ., concur.

Cited by (19)

A label shows how the later decision treated this one.

  • Metropolitan Radiological Imaging, P.C. v Country-Wide Ins. Co. (2008 NY Slip Op 50539(U)) FollowedA provider's prima facie no-fault showing does not require additional evidence establishing medical necessity.
  • Linden Med., P.C. v MVAIC (2008 NY Slip Op 52188(U)) FollowedAn arbitration claim against MVAIC is governed by the three-year limitations period in CPLR 214 (2), rather than a six-year period.
  • Matter of Boro Chiropractic P.C. v State Farm Fire & Cas. Co. (2013 NY Slip Op 50791(U)) FollowedA master arbitrator may not shift the insurer's burden of proving an EUO no-show to the provider to establish attendance.
  • Matter of American Tr. Ins. Co. v Heyligers (2026 NY Slip Op 04363) FollowedThe insurer failed to undermine the arbitrators' conclusions on the IME cut-off date and verification tolling.
  • R.J. Professional Acupuncturist, P.C. v Travelers Prop. Cas. Ins. Co. (2008 NY Slip Op 50541(U)) FollowedA provider establishes its prima facie no-fault claim by submitting complete proof of the fact and amount of loss and showing payment is overdue.
  • Preferred Med. Imaging, P.C. v Countrywide Ins. Co. (2009 NY Slip Op 52577(U)) FollowedAn arbitration award requiring a provider to establish medical necessity is contrary to settled law.
  • Matter of Hereford Ins. Co. v American Tr. Ins. Co. (2019 NY Slip Op 05778) FollowedThe loss-transfer award was upheld because its legal interpretation had a reasonable basis and did not contradict settled law.
  • Matter of MVAIC v Interboro Med. Care & Diagnostic PC (2010 NY Slip Op 04522)MVAIC's lack-of-coverage defense is not precluded by failure to pay or deny a no-fault claim within 30 days.
  • Matter of Fiduciary Ins. Co. v American Bankers Ins. Co. of Florida (2015 NY Slip Op 06343)An arbitrator may decide whether a carrier is an insurer subject to mandatory loss-transfer arbitration despite its nonappearance.
  • Matter of NY Med. Health P.C. v New York City Tr. Auth. (2009 NY Slip Op 51526(U))A self-insurer's unequivocal denial of all no-fault liability excuses later submission of proofs of claim before arbitration.
Show all 19 citing decisions
  • RDK Med. P.C. v General Assur. Co. (2005 NY Slip Op 51281(U))
  • Matter of Progressive N. Ins. Co. v Sentry Ins. A Mut. Co. (2008 NY Slip Op 04524)
  • Allstate Ins. Co. v Natural Healing Acupuncture, P.C. (2013 NY Slip Op 50645(U))
  • Preferred Med. Imaging, P.C. v Liberty Mut. Fire Ins. Co. (2006 NY Slip Op 50278(U))
  • Rj Professional Acupuncturist, P.C. v MVAIC (2008 NY Slip Op 51472(U))
  • Matter of American Tr. Ins. Co. v Nationwide Mut. Ins. Co. (2008 NY Slip Op 50295(U))
  • State Farm Mut. Auto. Ins. Co. v New York City Tr. Auth. (2009 NY Slip Op 50806(U))
  • AIU Ins. Co. v State Farm Ins. Co. (2010 NY Slip Op 51064(U))
  • State Farm Mut. Auto. Ins. Co. v Hereford Ins. Co. (2020 NY Slip Op 51304(U))

Similar decisions

  • Matter of State Farm Mut. Auto. Ins. Co. v Mutual Serv. Cas. Ins. Co. (2004 NY Slip Op 51293(U))The petitioning insurer's reimbursement demand was timely because it was made within three years of its first no-fault payment.
  • Matter of State Farm Mut. Auto. Ins. Co. v Motor Veh. Acc. Indem. Corp. (2006 NY Slip Op 00548)The petitioning insurer failed to establish grounds to vacate an arbitration award entered after proper notice and its nonparticipation.
  • Matter of Progressive Advanced Ins. Co. v New York City Tr. Auth. (2018 NY Slip Op 07432)A loss-transfer award declining an additional 20% wage offset had a reasonable basis and was not arbitrary or capricious.
  • Matter of Utica Mut. Ins. Co. (Selective Ins. Co. of Am.) (2006 NY Slip Op 02261)An internally inconsistent compulsory loss-transfer award may be vacated for failure to make a final and definite determination.
  • Matter of O’Neill v GEICO Ins. Co. (2018 NY Slip Op 04328)The SUM award denying benefits for lack of accident-related causation was rational, supported by evidence, and not arbitrary or capricious.
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