Appellate Division, Second Department
Jul 22, 2026
2026 NY Slip Op 04502
The adverse vehicle's policy administrator established valid Pennsylvania rescission within 60 days, defeating a permanent stay of UM arbitration. The petitioning insurer sought a stay and joinder of the administrator and adverse driver. Under Pennsylvania law, material application misrepresentations permitted retroactive rescission as to the insured; rescission beyond 60 days was precluded as to innocent third parties. The administrator proved rescission ab initio within that period, rebutting the petitioning insurer's preliminary showing. The claimant could seek coverage under the policy insuring the claimant's own vehicle. The Appellate Division, Second Department, reversed the order, insofar as appealed from, denied the permanent stay and joinder, and remitted for a new determination of the requested temporary stay pending discovery under CPLR article 75.
Appellate Division, First Department
Jul 9, 2026
2026 NY Slip Op 04363
Provider prevailed
The insurer failed to undermine the arbitrators' conclusions on the IME cut-off date and verification tolling. The Appellate Division, First Department, affirmed denial of the CPLR article 75 petition, although it was timely under CPLR 7511 (a) because it followed required master arbitration review under 11 NYCRR 65-4.10 (a). The arbitrator used the provider's receipt of termination notice as the cut-off; the insurer did not address that ground or reliance on an Insurance Department opinion requiring timely denial. The insurer also failed to challenge findings that requested verification had been supplied and the unanswered request sought previously furnished information. Under 11 NYCRR 65-3.8 (a) (1), the arbitrator reasonably found tolling ended. Both awards had a rational basis.
Appellate Division, Second Department
Jul 8, 2026
2026 NY Slip Op 04292
Provider prevailed
An arbitrator may not raise a standing defense that the insurer failed to assert in the arbitration proceeding. The arbitrator denied the provider's no-fault claims because the provider failed to establish that its owner or employees, rather than independent contractors, supplied the services. A master arbitrator affirmed. Under CPLR 7511 (b), an award may be vacated when an arbitrator exceeds the arbitrator's authority and prejudices a party's rights. That authority extends only to issues presented by the parties and excludes unpleaded affirmative defenses. The Appellate Division, Second Department, affirmed the order, insofar as appealed from, vacating the master arbitration award and denying the insurer's cross-petition to confirm it.
Appellate Division, Second Department
Jul 8, 2026
2026 NY Slip Op 04293
Insurer prevailed
The provider's additional attorney's fee motion failed because no valid denied or overdue claim had been determined when it moved. Supreme Court had vacated a master arbitration award rejecting the claims for failure to prove standing and referred them to arbitration for further proceedings. That ruling did not establish entitlement to payment. Insurance Law § 5106 (a) and 11 NYCRR 65-4.10 (j) (4) permit fees for securing payment of a valid claim that was denied or overdue. The Appellate Division, Second Department, reversed the money judgment awarding additional fees and denied the provider's motion. It dismissed the separate appeal from the order because the money judgment superseded it.
Appellate Division, Second Department
Jul 8, 2026
2026 NY Slip Op 04290
Provider prevailed
The provider obtained vacatur of a second master arbitration award denying claims on standing grounds, and that order was affirmed. The award repeated a previously vacated sua sponte standing determination without new explanation. The Appellate Division, Second Department, affirmed the order, insofar as appealed from, relying on the companion appeal decided the same day, leaving the insurer's cross-petition for confirmation denied.
Appellate Division, Second Department
Jul 8, 2026
2026 NY Slip Op 04291
Split result
The provider's unreasonable arbitration delay required excluding September 10, 2003, through November 6, 2018, from statutory interest. After arbitration was dismissed without prejudice, the provider pursued litigation despite its election of arbitration, then recommenced arbitration. The Appellate Division, Second Department, found the determination of no unreasonable delay lacked evidentiary support and a rational basis under 11 NYCRR 65-3.9 (d). It modified the judgment to exclude that period, while upholding the principal award and compound interest under former 11 NYCRR 65.15 (h), applicable when the accident and claim submission occurred. It remitted for interest recalculation and appellate attorney's fees under 11 NYCRR 65-4.10 (j) (4). The requested stay pending a related appeal was academic.
Appellate Division, Second Department
Jul 8, 2026
2026 NY Slip Op 04303
Insurer prevailed
The claimant's assault injuries did not arise from the inherent nature or use of the uninsured vehicle, warranting a permanent arbitration stay. After a collision, the uninsured driver allegedly walked to the claimant's taxicab and struck the claimant with an ashtray. Although the event was unexpected from the claimant's perspective under State Farm Mut. Auto. Ins. Co. v Langan, coverage under 11 NYCRR 60-2.3 (f), Insuring Agreements (II), required injuries arising from the uninsured vehicle's ownership, maintenance or use. The vehicle merely contributed to the condition producing the injuries; the alleged assault caused them. The Appellate Division, Second Department, affirmed the permanent stay under CPLR article 75. The claimant's remaining contention was improperly raised for the first time on appeal.
Trial court, Second Department
Jul 28, 2026
2026 NY Slip Op 51163(U)
Insurer prevailed
The provider's affidavits from an unrelated matter failed to rebut mailing proof supporting the insurer's EUO nonappearance defense. The Civil Court, Kings County, granted the insurer summary judgment under CPLR 3212 and dismissed the complaint with prejudice. Standard mailing-procedure affidavits established mailing, and the insurer demonstrated nonappearance at two duly scheduled EUOs. Although potentially admissible in form under CPLR 3212 (b), the provider's rebuttal affidavits concerned different claims and defenses, lacked accompanying papers authenticating their context and were irrelevant. The attempted impeachment under CPLR 4514 concerned use of a mailing service on a collateral issue and was barred under Badr v Hogan. The provider also offered no direct evidence from a person with knowledge of nonreceipt.
Trial court, First Department
Jul 13, 2026
2026 NY Slip Op 51484(U)
Provider prevailed
The insurer failed to prove proper mailing of IME notices or nonappearance, given an address discrepancy and a defective affirmation. The Civil Court, New York County, denied the insurer's summary judgment motion without prejudice. The IME scheduling letters used an address identifying Jamaica, while the NF-2 listed South Richmond Hill, and the insurer did not address the discrepancy in reply. The physician's affirmation concerning nonappearance omitted the complete penalty clause required by CPLR 2106 and was insufficient to support the motion. Because the insurer failed to meet its prima facie burden under CPLR 3212 (b), the burden never shifted to the provider to raise a triable issue.
Trial court, Second Department
Jul 9, 2026
2026 NY Slip Op 51108(U)
Insurer prevailed
A SUM insurer's statutory notice duty does not require advising insureds to purchase additional coverage. The Supreme Court, Rockland County, granted the insurer summary judgment dismissing the insureds' breach-of-contract and negligence claims. The contract claim was barred by the six-year statute of limitations, applying the reasoning of an earlier dismissal involving the insurance agents. That earlier ruling did not resolve the insurer's separate statutory duties under the law-of-the-case doctrine. Nevertheless, the SUM endorsement and declaration pages satisfied Insurance Law § 3420 (f) (2) (A) by providing the required definitions, availability and coverage-limit information. The policy required the insureds to contact an agent if they wanted additional SUM coverage, and they raised no material factual issue.
Trial court, Second Department
Jul 2, 2026
2026 NY Slip Op 51282(U)
Split result
The provider failed to justify five late bills to MVAIC but established proper mailing of three bills MVAIC denied receiving. The Civil Court, Richmond County, granted MVAIC summary judgment dismissing the five claims submitted beyond the 45-day limit in 11 NYCRR 65-1.1. The denials offered to excuse lateness upon reasonable justification, but no additional materials were submitted. Cover letters stating that bills were initially sent to another insurer did not explain why or when the provider learned MVAIC was the proper recipient. For the remaining three bills, the billing administrator's affidavit and USPS-stamped mailing proof established the provider's prima facie case. The court denied MVAIC's motion and granted the provider's cross motion only to that extent, referring MVAIC's remaining defenses to trial.
