The Rogak Report: 22 Jan 2008 (Part II) ** No Fault - Master Arbitration **
MASTER ARBITRATOR'S DENIAL OF NO-FAULT BENEFITS UPHELD
Queens Community Medical P.C. a/a/o Michael Boyce v. Motor Vehicle Accident Indemnification Corp. 2008 NYSlipOp 50089(U) Decided on January 8, 2008 Appellate Term, Second Department Edited by Lawrence N. Rogak
Queens Community Medical, P.C. (QCM) 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. Motor Vehicle Accident Indemnification Corporation (MVAIC) cross-petitioned to confirm the master arbitrator's award per CPLR 7510. The Civil Court, Kings County, vacated the master arbitrator's award and awarded QCM the principal sum of $8,130.88. This appeal by MVAIC ensued. The Appellate Term reversed.
"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]. Inasmuch as the master arbitrator determined that, based upon the documents submitted to the arbitrator, the arbitrator had a rational basis for finding that QCM failed to sustain its burden of demonstrating a prima facie case of medical necessity, the master arbitrator's determination was not arbitrary, capricious or irrational. We note that the denial of claim forms issued by MVAIC were not annexed to the petition which sought vacatur of the master arbitrator's award. Accordingly, the record does not support a determination that the arbitrator's decision was based on a precluded defense."
"MVAIC's cross petition to confirm the master arbitrator's award was unnecessary since CPLR 7511 (e) mandates an automatic confirmation upon denial of a motion to vacate or modify."