Key Takeaway
Nassau County court grants trial de novo and declares no coverage in Allstate v. Phelps case, finding stroke treatment unrelated to motor vehicle accident.
This article is part of our ongoing arbitrations coverage, with 231 published articles analyzing arbitrations issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Allstate Ins. Co. v. Phelps Memorial Hospital, 2013 NY Slip Op 33590(U)(Sup. Ct. Nassau Co. 2013)
“This Court conducted a non-jury trial on matter on November 7, 2013, and
reserved decision. The plaintiffs expert credibly testified the treatment rendered to Jorge Caniero was neither caused by the November 18, 2010 motor vehicle accident nor was there any exacerbation of a pre-existing condition caused by that same accident. The Court finds Jorge Caniero was admitted to Phelps Memorial Hospital on suspicion he experienced a stroke which was not related to the November 18, 20 I 0 motor vehicle accident. The Court also finds the treatment rendered by the defendant was related to the diagnosis of acute CVA hypertension, diabetes, mellitus, coronary artery disease and hyperlipidemia. These conditions were not causally related to the November 18, 2010 motor vehicle accident.”
…
“The plaintiff proffered medical facts by its expert which were sufficient to show the medical condition for which Jorge Caniero was treated was not related to the November 18, 2010 motor vehicle accident nor was there any exacerbation of a pre-existing condition caused by that same accident”
This is an interesting order as it is one of the few times a lack of causation defense has actually been successful. It seems to help that Defendant did not put on a case? If you look at the history of this matter, Defendant made a motion to dismiss the action as time barred, presumably because the Trial de-novo/declaratory judgment action was not commenced within the 90-day period set forth in Article 75 of the CPLR. This motion was denied.
I suspect Defendant’s motion should have probably been granted. The simple reason is that assuming the demand for trial de-novo occurs more than 6-years after the claim became overdue, while the original arbitration was commenced timely, then the trial de novo would be time barred. I am not sure that makes sense and is in accord with the meaning of Ins. Law 5106(c).
Related Articles
- Causation challenges when seeking trial de novo after master arbitrator affirmation
- Article 75 petition granted with remand to AAA arbitration
- Business record entries and motor vehicle accident causation
- Neurologist’s insufficient affirmation on causal connection
- Personal Injury
Legal Update (February 2026): Since this 2014 post, New York’s no-fault regulations under 11 NYCRR 65 have undergone multiple amendments affecting causation standards and coverage determinations. Practitioners should verify current provisions regarding medical necessity criteria, expert testimony requirements, and procedural rules for declaratory judgment actions under Insurance Law § 5106, as regulatory changes may have modified the framework for successful causation defenses.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
No-Fault Arbitrations in New York
No-fault arbitration is the primary forum for resolving disputes between medical providers and insurers over claim denials. The arbitration process has its own procedural rules, evidentiary standards, and appeal mechanisms — including master arbitration and Article 75 judicial review. Understanding arbitration practice is essential for any attorney handling no-fault claims. These articles cover arbitration procedures, hearing strategies, award enforcement, and the grounds for challenging arbitration outcomes in court.
231 published articles in Arbitrations
Keep Reading
More Arbitrations Analysis
Forced Arbitration: Challenges in Discrimination Claims
Explores forced arbitration in discrimination claims, examining laws with the 2021 EFAA, impacting employee rights and employer policies.
Feb 11, 2025IME no-show is a policy defense triggering the hourly attorney fee provision
Learn how IME no-show defenses trigger hourly attorney fee provisions in NY no-fault insurance. Court rules failure to attend IME is policy defense.
May 22, 2021Out of scope – out of mind
Appellate court ruling on expert witness qualifications in personal injury cases - physicians must establish foundation when testifying outside their specialty area.
May 24, 2018SUM Coverage
Learn about SUM (Supplemental Uninsured/Underinsured Motorist) coverage in NY. Essential protection when other drivers lack adequate insurance. Legal case analysis.
Dec 4, 2015Absence of a business record entry = no motor vehicle accident
Expert analysis of Jesa Med. Supply v NYC Transit Authority and business records evidence. Learn how absent records affect personal injury cases in NY.
Feb 15, 2013A default that is more than meets the eyes
Understand the complex implications of default judgments in NY no-fault cases. Learn strategic defense approaches and collateral estoppel consequences.
Sep 18, 2009Common Questions
Frequently Asked Questions
How does no-fault arbitration work in New York?
No-fault arbitration is conducted under the American Arbitration Association's rules. The claimant (usually a medical provider) files a request for arbitration after the insurer denies a claim. An assigned arbitrator reviews written submissions from both sides — including medical records, denial letters, peer reviews, and legal arguments — and issues a written decision. Arbitration awards can be confirmed in court under CPLR Article 75, and either party can appeal to a master arbitrator. No-fault arbitration is generally faster and less expensive than litigation.
What is CPLR Article 75?
CPLR Article 75 governs arbitration in New York, including the procedures for confirming, vacating, and modifying arbitration awards. In no-fault practice, Article 75 is used to convert arbitration awards into enforceable court judgments. A petition to confirm or vacate an arbitration award must be filed within one year of the award being delivered (CPLR 7510). Courts can vacate awards on narrow grounds, including corruption, fraud, arbitrator misconduct, or the arbitrator exceeding their power.
How is causation established in New York personal injury cases?
Causation requires proof that the defendant's conduct was a substantial factor in causing the plaintiff's injuries. In motor vehicle and slip-and-fall cases, medical experts typically establish causation through review of the patient's medical history, diagnostic imaging, clinical examination findings, and the temporal relationship between the accident and the onset of symptoms. The plaintiff must also address any pre-existing conditions and demonstrate that the accident was a proximate cause of the current complaints.
What are common coverage defenses in no-fault insurance?
Common coverage defenses include policy voidance due to material misrepresentation on the insurance application, lapse in coverage, the vehicle not being covered under the policy, staged accident allegations, and the applicability of policy exclusions. Coverage issues are often treated as conditions precedent, meaning the insurer bears the burden of proving the defense. Unlike medical necessity denials, coverage defenses go to whether any benefits are owed at all.
What happens if there's no valid insurance policy at the time of the accident?
If there is no valid no-fault policy covering the vehicle, the injured person can file a claim with MVAIC (Motor Vehicle Accident Indemnification Corporation), which serves as a safety net for people injured in accidents involving uninsured vehicles. MVAIC provides the same basic economic loss benefits as a standard no-fault policy, but the application process has strict requirements and deadlines.
Was this article helpful?
About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a arbitrations matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.