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January 17, 2024

Time to Care Pharm. Inc. v American Tr. Ins. Co. (2024 NY Slip Op 50126(U))

https://www.beynensonlaw.com/case-law/time-to-care-pharm-inc-v-american-tr-ins-co-2024-ny-slip-op-50126u/

Court
District Court of Suffolk County, Second District
Judge
Hennings, J.
Decided
January 17, 2024
Citation
2024 NY Slip Op 50126(U)
Posture
Article 75 petition
Outcome
Provider prevailed
Issues
CPLR article 75 (arbitration awards) Interest and attorney fees
Legal questions
Court review of arbitration awards · Attorney's fees: article 75 and appeals (see the maps)
Cite as
Time to Care Pharm. Inc. v American Tr. Ins. Co., 2024 NY Slip Op 50126(U) (Dist Ct, Suffolk County, 2d Dist 2024)

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 provider's arbitration award was confirmed because the record supplied a rational basis and supported the master arbitrator's affirmance. The District Court, Suffolk County, granted the provider's unopposed petition under CPLR 7510, filed within one year after delivery of the master arbitration award. The award had not been vacated or modified on a ground specified in CPLR 7511. The master arbitrator found the initial award clearly articulated and supported by the evidence, with no valid ground to set it aside. The court agreed and confirmed the award, including interest under Insurance Law § 5106 (a), and granted additional attorney fees for the judicial proceeding under 11 NYCRR 65-4.10 (j) (4).

Reported in New York Official Reports at Time to Care Pharm. Inc. v American Tr. Ins. Co. (2024 NY Slip Op 50126(U))

[*1]
Time to Care Pharm. Inc. v American Tr. Ins. Co.
2024 NY Slip Op 50126(U)
Decided on January 17, 2024
District Court Of Suffolk County, Second District
Hennings, J.
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This opinion is uncorrected and will not be published in the printed Official Reports.


Decided on January 17, 2024
District Court of Suffolk County, Second District


Time to Care Pharmacy Inc., a/a/o MALIK BROOMES, Petitioner,

against

American Transit Insurance Co., Respondent.




Index No. CV-0538-23/BA


Attorney for the petitioner is Jason Tenenbaum, Esq.
Paul E. Hennings, J.

Recitation, as required by CPLR 2219(a), of the papers considered in the review of petitioner’s petition numbered 1 to 5 read on this motion by petitioner for an order confirming the Master Arbitration Award that affirmed the Arbitration Award below by Notice of Petition/Order to Show Cause and petitioner’s papers 1-5 ; Notice of Cross Motion and supporting papers; Answering Affidavits and supporting papers ; Replying Affidavits and supporting papers; Filed papers ; Other; (and after hearing counsel and/or parties in support of and opposed to the motion), and due deliberation and consideration having been had therein, the Decision and Order of the Court on the petition is as follows:

it is

ORDERED that the unopposed petition, pursuant to CPLR 7510, timely seeking Confirmation of the Master Arbitration Award of Toby Susan DeSimone, Esq. (“DeSimone”) rendered on 04/27/2023, and mailed on 05/01/2023 (“delivery date”), is GRANTED, DeSimone having been duly appointed by the Superintendent of Insurance and designated by the American Arbitration Association pursuant to the Regulations promulgated by the Superintendent of Insurance as 11 NYCRR §65-4.10, which application was made within one year after delivery below of said award to petitioner, which award has not been vacated or modified upon a ground specified in CPLR 7511 (see CPLR 7510; see also Matter of Neiss v Asia, 164 AD3d 1344, 1345 [2nd Dept 2018]).

The Master Arbitration Award reviewed and affirmed in its entirety the Arbitration Award below, heard on 12/13/2022 and affirmed on 01/12/2023, of the Arbitrator Inez Beyrer, which was entered in favor of petitioner, TIME TO CARE PHARMACY INC., a/a/o MALIK BROOMES, as against respondent, in accordance with the Rules for New York State No-Fault Arbitration adopted pursuant to regulations promulgated by the Superintendent of Insurance.

More than 21 days has elapsed since the Master Arbitration Award was issued and mailed on 05/01/2023 (“date of delivery”), and the amounts set forth in the Master Arbitration Award is now due and owing (see 11 NYCRR §65-4.10[e][4]).

The Arbitration Award is confirmed in favor of petitioner as against respondent, in the following sums: (i) Principal sum in the amount of $3,381.36; (ii) Interest on the Principal at 2% per month from 09/28/2021 until entry of a judgment in accordance with Insurance Law §5106(a); (iii) Attorney Fee in the sum of 20% of the principal and interest to a maximum of $1,360.00; (iv) Arbitration Filing Fee in the amount of $40.00 (see 11 NYCRR §65-4.10[e][1][ii][b]); (v) Master Arbitration Fee in the sum of $195.00 (see 11 NYCRR §65-4.10[e] [1][ii][a]); (vi) Additional Attorney Fee pursuant to Insurance Department Regulations (see 11 NYCRR §65-4.10[j][4]), for services rendered in a Court appeal from a Master Arbitration Award, to be fixed by the Court adjudicating the matter (see Geico Ins. Co. v AAAMG Leasing Corp., 148 AD3d 703 [2nd Dept 2017]); and it is further

ORDERED that the unopposed petition for an order awarding additional attorney fees for post arbitration proceedings, is GRANTED. Petitioner is granted additional attorney fees in the sum of $1,000.00 (see 11 NYCRR §65-4.10[j][4]; see also D&W Cent. Stat. Fire Alarm Co. Inc. v United Props. Corp., 34 Misc 3d 85 [App Term, 2nd Dept, 11th & 13th Jud Dists 2012]).

The standard of review for an arbitration award is limited to a determination of whether the award was arbitrary, capricious and incorrect as a matter of law. A master arbitrator’s powers in reviewing an initial arbitrator’s decision are limited to the grounds stated in CPLR 7511, and additionally, under insurance regulations, is limited to whether the initial arbitrator ruled on factual and procedural issues in a manner that was arbitrary, capricious, irrational or without a plausible basis (see Matter of Petrofsky v Allstate Ins. Co., 54 NY2d 207, 211 [1981]; In the Matter of Allstate Ins. Co. v Keegan, 201 AD2d 724 [2nd Dept 1994]).

If a challenge is based upon a factual error in the arbitration, “the master arbitrator must uphold the determination if it has a rational basis” (see In the Matter of Richardson v Prudential Prop. & Cas. Ins. Co., 230 Ad2d 861 [2nd Dept 1996]). Moreover, an arbitrator’s award must be upheld “when the arbitrator ‘offer[s] even a barely colorable justification for the outcome reached'” (see In the Matter of Susan D. Settenbrino. P.C. v Barroga-Hayes, 89 AD3d 1094, 1095 [2nd Dept 2011]). Indeed, for an award to be irrational, there must be “no proof whatsoever to justify the award” (see In the Matter of Gaymon v MTA Bus Co., 117 AD3d 735, 736 [2nd Dept 2014]; In the Matter of Susan D. Settenbrino. P.C. v Barroga-Hayes, supra ). However, “an arbitrator is not bound by principles of substantive law or rules of evidence, and may do justice and apply his or her own sense of law and equity to the facts as he or she finds them to be” (Id. at 1095).

Here, the Court determines that the Master Arbitrator found that the lower arbitrator decided the claim based upon her review and evaluation of the record, with pertinent case law, and further found the award below was clearly articulated and had a rational and plausible basis in the evidence. Moreover the Master Arbitrator further found there was no evidence presented which would establish any valid ground to set aside the award of the lower arbitrator, and found no reason to disturb her decision, thereby affirming the lower arbitration award in its entirety.

After due consideration, the Court agrees with the findings of the Master Arbitrator and finds that the record demonstrates there was a rational basis for the initial arbitrator’s decision and the award was justified. In addition, the Master Arbitration Award was supported by sufficient evidence in the record, and was not arbitrary, capricious, irrational or incorrect as a [*2]matter of law.

The foregoing constitutes the decision and order of this Court. Submit Judgment.

Dated: January 17, 2024
J.D.C.

Legal questions (2)

Questions 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.

Court review of arbitration awards

Open the full map

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

Confirmed the master arbitration award on the provider's unopposed petition, finding the lower award had a rational basis and was not arbitrary, capricious or incorrect as a matter of law.

  • Court of AppealsCt App 1
  • Appellate DivisionApp Div 34
  • Appellate TermApp Term 46
  • Trial courtsTrial 38
2010, Court of Appeals: 1 decision (1 Award stands)2022, Appellate Division: 1 decision (1 Vacated: irrational/arbitrary)2019, Appellate Division: 6 decisions (3 Award stands, 1 Vacated: irrational/arbitrary, 2 Vacated: master overstepped)2018, Appellate Division: 2 decisions (1 Award stands, 1 Vacated: irrational/arbitrary)2017, Appellate Division: 1 decision (1 Award stands)2016, Appellate Division: 1 decision (1 Award stands)2015, Appellate Division: 1 decision (1 Award stands)2013, Appellate Division: 1 decision (1 Award stands)2010, Appellate Division: 2 decisions (2 Award stands)2007, Appellate Division: 2 decisions (1 Vacated: irrational/arbitrary, 1 Vacated: exceeded power)2005, Appellate Division: 2 decisions (2 Award stands)2025, Appellate Division: 5 decisions (5 Award stands)2026, Appellate Division: 9 decisions (6 Award stands, 1 Vacated: irrational/arbitrary, 2 Vacated: exceeded power)2009, Appellate Division: 1 decision (1 Award stands)2020, Appellate Term: 2 decisions (1 Award stands, 1 Vacated: master overstepped)2019, Appellate Term: 1 decision (1 Award stands)2017, Appellate Term: 4 decisions (4 Award stands)2016, Appellate Term: 2 decisions (2 Award stands)2011, Appellate Term: 1 decision (1 Award stands)2010, Appellate Term: 3 decisions (3 Award stands)2009, Appellate Term: 1 decision (1 Award stands)2008, Appellate Term: 11 decisions (7 Award stands, 4 Vacated: irrational/arbitrary)2007, Appellate Term: 14 decisions (14 Award stands)2006, Appellate Term: 3 decisions (3 Award stands)2023, Appellate Term: 1 decision (1 Vacated: irrational/arbitrary)2024, Appellate Term: 1 decision (1 Vacated: irrational/arbitrary)2025, Appellate Term: 1 decision (1 Award stands)2004, Appellate Term: 1 decision (1 Award stands)2023, Trial courts: 13 decisions (12 Award stands, 1 Vacated: irrational/arbitrary)2019, Trial courts: 1 decision (1 Award stands)2017, Trial courts: 1 decision (1 Vacated: master overstepped)2015, Trial courts: 2 decisions (2 Award stands)2013, Trial courts: 2 decisions (2 Vacated: irrational/arbitrary)2008, Trial courts: 1 decision (1 Award stands)2006, Trial courts: 1 decision (1 Vacated: irrational/arbitrary)2005, Trial courts: 7 decisions (5 Award stands, 2 Vacated: irrational/arbitrary)2004, Trial courts: 1 decision (1 Vacated: irrational/arbitrary)2024, Trial courts: 3 decisions (3 Award stands)2026, Trial courts: 1 decision (1 Award stands)2009, Trial courts: 2 decisions (1 Award stands, 1 Vacated: irrational/arbitrary)2011, Trial courts: 1 decision (1 Award stands)2016, Trial courts: 1 decision (1 Award stands)2018, Trial courts: 1 decision (1 Vacated: exceeded power)This decision
20052010201520202025
Award standsVacated: irrational/arbitraryVacated: exceeded powerVacated: master oversteppedThis decision

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.

Attorney's fees: article 75 and appeals

Open the full map

How is the applicant’s attorney’s fee fixed for no-fault article 75 proceedings, de novo actions and appeals?

This decision: Court fixes a reasonable amount itself, or upholds the amount fixed below as within its discretion (rules on the question, but another ground decided the case)

Granted the unopposed request for additional attorney's fees for the post-arbitration proceeding under 65-4.10 (j) (4), fixing them at $1,000.

  • Appellate DivisionApp Div 44
  • Appellate TermApp Term 3
  • Trial courtsTrial 11
2019, Appellate Division: 4 decisions (3 Fee due; court to fix, 1 No fee recoverable)2018, Appellate Division: 1 decision (1 No fee recoverable)2017, Appellate Division: 1 decision (1 Fee due; court to fix)2016, Appellate Division: 1 decision (1 Limited to regulatory schedule)2025, Appellate Division: 13 decisions (4 Fee due; court to fix, 9 Amount fixed or upheld)2026, Appellate Division: 24 decisions (11 Fee due; court to fix, 3 Amount fixed or upheld, 4 Amount set aside, 6 No fee recoverable)2020, Appellate Term: 1 decision (1 Fee due; court to fix)2025, Appellate Term: 2 decisions (1 Fee due; court to fix, 1 Amount set aside)2023, Trial courts: 7 decisions (2 Amount fixed or upheld, 5 Limited to regulatory schedule)2024, Trial courts: 2 decisions (1 Amount fixed or upheld, 1 No fee recoverable)2026, Trial courts: 1 decision (1 No fee recoverable)2011, Trial courts: 1 decision (1 Fee due; court to fix)This decision
201520202025
Fee due; court to fixAmount fixed or upheldAmount set asideLimited to regulatory scheduleNo fee recoverableThis decisionCites it or cited by itCited or followed

Of the 58 decisions on this question in the Second Department courts and the Court of Appeals, 15 (this one included) are in the same category.

Cited in this decision

  • Matter of GEICO Ins. Co. v AAAMG Leasing Corp. (2017 NY Slip Op 01552)A provider may recover an additional attorney's fee for an article 75 proceeding to confirm or vacate a master arbitration award.

Similar decisions

  • American Tr. Ins. Co. v Trinity Pain Mgt. of Staten Is., PLLC (2023 NY Slip Op 51337(U))The insurer's petition to vacate a no-fault award was denied because its policy-exhaustion evidence was insufficient.
  • Matter of American Tr. Ins. Co. v Atlantic Med. Care, P.C. (2025 NY Slip Op 07297)A master arbitrator's legal error does not warrant vacatur unless the determination is irrational.
  • Matter of American Tr. Ins. Co. v Midland Pharm. Yonkers Corp. (2026 NY Slip Op 06193)A master arbitration award must be affirmatively confirmed when a petition to vacate it is denied under CPLR 7511 (e).
  • Matter of Spartan Med. Supply v Liberty Mut. Ins. Co. (2019 NY Slip Op 50862(U))The master arbitrator's affirmance of a policy-exhaustion denial was rational despite conflicting appellate authority.
  • Matter of American Tr. Ins. Co. v Sovereign Med. Servs., P.C. (2026 NY Slip Op 03160)The master arbitrator's application of collateral estoppel to reject a verification defense was rational and supported by evidence.
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