New York Personal Injury Protection
Arbitration Forums, Inc. (AF) is pleased and honored to have served as the arbitration administrator for the mandatory No-Fault Intercompany Arbitration Program for the New York State Department of Financial Services since its implementation in the early 1970's.
Section 5105 of New York’s Comprehensive Motor Vehicle Reparations Act (No-Fault Law) mandates insurers, self-insurers, and workers’ compensation providers to arbitrate disputes pursuant to the provisions of section 5105 and 5221(b) of the New York Insurance Law. Section 65-4.11 of Insurance Department Regulation 68 contains Procedures that apply to this mandatory arbitration process and designates AF as the administrator. There are no signatory or member companies in New York No-Fault Arbitration. Arbitration is mandatory for all companies and their subsidiaries pursuant to New York Insurance Law Section 5107 and 11 NYCRR 68-D Section 65-4.11.
There are two general categories of disputes that are resolved in the program:
- LOSS TRANSFER
- PRIORITY OF PAYMENT
Loss Transfer cases are filed to recover No-Fault Payments made to an injured party as a result of an accident or occurrence involving a vehicle that weighs over 6,500 lbs. unloaded, or, is a vehicle-for-hire used principally for the transportation of persons or property (including livery). Loss transfer liability is based on the New York Pure Comparative Negligence Law.
EXAMPLE: A driver and/or passenger in a personal automobile sustains an injury as a result of an accident with a taxi, limousine or commercial truck (weighing more than 6,500 lbs. unloaded). The driver's carrier pays the claim(s) and files arbitration against the taxi's automobile liability carrier (or cab company if self- insured) if a settlement cannot be negotiated. The arbitrator will apportion liability and consider damages, if contested.
Priority of Payment disputes are submitted pursuant to Section 65-3.12(b), which states:
"If a dispute regarding priority of payment arises among insurers who otherwise are liable for the payment of first-party benefits, then the first insurer to whom notice of claim is given pursuant to section 65-3.3 or 65-3.4(a) of this Subpart, by or on behalf of an eligible injured person, shall be responsible for payment to such person. Any such dispute shall be resolved in accordance with the arbitration procedures established pursuant to section 5105 of the Insurance Law and section 65-4.11 of this Part."
EXAMPLE: There is a one-vehicle accident in which a pedestrian is injured. The injured pedestrian makes a no-fault claim with the Applicant Company (his or her own carrier or that of a resident relative). The Applicant Company files arbitration and names the primarily responsible carrier, e.g. the insurer of the vehicle that struck the pedestrian. The arbitrator looks to the policy, and/or contracts, and to the law to determine who should have paid for the loss.
Mandatory arbitration of such controversies applies to insurers, self-insurers and compensation providers. All insurers, self-insurers and compensation providers must submit disputes arising out of accidents, insured events or occurrences within the jurisdiction of sections 5105 or 5221(b) of the Insurance Law to mandatory arbitration.
View the Rules Document for New York No-Fault Intercompany Arbitration.
Intercompany Reimbursement Notification Form
Click here to review the NY PIP FAQ that is frequently updated in response to member inquiries.
To learn if an out-of-state insurance company has filed a Power of Attorney with the New York Department of Motor Vehicles (DMV) stating that it will adapt its policies to New York when its insureds travel in New York, an email request should be made directly to firstname.lastname@example.org.
Click here to get Helpful Hints for the NY No-Fault Arbitration process.
(12 minutes) - This tutorial will enable you to identify the mandatory arbitration claim types, apply the New York regulation and describe the arbitration procedures. (Published 04/29/10)