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Matter of Howard v. Cigna Insurance Company

Appellate Division of the Supreme Court of New York, Second Department
May 17, 1993
193 A.D.2d 745 (N.Y. App. Div. 1993)

Opinion

May 17, 1993

Appeal from the Supreme Court, Kings County (Vinik, J.).


Ordered that the order and judgment is affirmed, with costs.

The respondent insurer denied the petitioner insured's claim for no-fault benefits because a bill for housekeeping expenses was not presented within 180 days after the services were rendered. The insured then sought arbitration. The arbitrator held that even if the 180-day rule was inapplicable to the insured's claim, the claim would be denied on the grounds that the insured failed to prove the need for the services, and the insured failed to submit the claim until almost three years after services had ceased, which was prejudicial to the insurer. That determination was affirmed by the master arbitrator.

The insured contends that the arbitrator exceeded his power by addressing the issues of need and prejudice, and that the arbitrator had only the power to address the 180-day rule as set forth in the denial of claim. We conclude to the contrary.

It is well-settled that an arbitrator is not required to justify his or her award. It must merely appear that there exists a rational basis for the award (see, Singletary v Government Empls. Ins. Co., 139 A.D.2d 723). In Matter of Panton v Allstate Ins. Co. ( 173 A.D.2d 831) the insured sought no-fault benefits for expenses incurred more than five years prior to the filing of the claim. The court ruled that the arbitrator's refusal to grant the claim, on the ground that the insurer would be unable to verify the claim because of the delay, was not irrational or contrary to public policy. So too here, the arbitrator's findings were not so irrational as to require vacatur. Mangano, P.J., Thompson, Balletta and Lawrence, JJ., concur.


Summaries of

Matter of Howard v. Cigna Insurance Company

Appellate Division of the Supreme Court of New York, Second Department
May 17, 1993
193 A.D.2d 745 (N.Y. App. Div. 1993)
Case details for

Matter of Howard v. Cigna Insurance Company

Case Details

Full title:In the Matter of ELAINE HOWARD, Appellant, v. CIGNA INSURANCE COMPANY…

Court:Appellate Division of the Supreme Court of New York, Second Department

Date published: May 17, 1993

Citations

193 A.D.2d 745 (N.Y. App. Div. 1993)
597 N.Y.S.2d 730

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