[*1]
American Tr. Ins. Co. v Athena Chiropractic PC
2025 NY Slip Op 51499(U) [87 Misc 3d 1208(A)]
Decided on July 21, 2025
Supreme Court, New York County
Lebovits, 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This opinion is uncorrected and will not be published in the printed Official Reports.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 July 21, 2025
Supreme Court, New York County


American Transit Insurance Company, Plaintiff,

against

Athena Chiropractic PC, Defendant.




Index No. 653507/2025



Larkin Farrell LLC, New York, NY (Joshua Mak of counsel), for petitioner.

No appearance for respondent.


Gerald Lebovits, J.

Petitioner, American Transit Insurance Company, moves without opposition under CPLR article 75 to vacate a no-fault arbitration award in favor of respondent, Athena Chiropractic, PC. The arbitrator held (and the master arbitrator affirmed) that absent evidence that petitioner had not received requested verification from respondent, respondent was entitled to payment on some (but not all) of its no-fault claims. Petitioner now moves to vacate the arbitration decision and the master arbitrator's decision affirming it. The motion is denied.

The arbitrator relied on no-fault caselaw holding that when a no-fault insurer argues that its obligation to pay no-fault bills has not yet been triggered because requested verification remains outstanding, the insurer must establish prima facie that it timely mailed verification requests to the claimant but did not receive the requested verification. (See NYSCEF No. 3 at 3, [*2]citing Island Life Chiropractic, P.C. v Travelers Ins. Co., 2019 NY Slip Op 51273[U] (App Term 2d Dept 2019].) The arbitrator concluded that petitioner did not meet that prima facie burden because it "failed to submit credible evidence that it did not receive the requested verification." (Id.) On this motion, petitioner does not argue that the arbitrator acted contrary to settled law in relying on the rule discussed in Island Life Chiropractic. Nor does petitioner contend that the arbitrator overlooked evidence submitted by petitioner (such as an affidavit) that would satisfy its prima facie burden to show non-receipt of requested verification.

Instead, petitioner asserts, the question is who should win "if the response to verification was mailed but not received"—and that in that scenario "the arbitrator doesn't just get to choose" in claimant's favor. (NYSCEF No. 1 at ¶ 64.) This assertion begs the key question: Whether verification was (or was not) received by the insurer. Petitioner has not shown that the arbitrator's answer to that question lacked support in the record or was contrary to well-settled law.

Accordingly, it is

ORDERED that American Transit's petition to vacate the arbitration award in favor of respondent Athena Chiropractic PC, is denied, and the proceeding is dismissed, no costs; and it is further

ORDERED that American Transit serve a copy of this order on Athena Chiropractic PC, by certified mail, return receipt requested, directed to its last-known address; and on the office of the County Clerk (using the NYSCEF filing event "Notice to the County Clerk - CPLR § 8019 (c)"), which shall enter judgment accordingly.



DATE 7/21/2025