No-Fault Claims and Arbitration
If you submit a No-Fault claim to an insurance company and the insurer does not respond to your submission within 30 days of its receipt, or if the insurer issues a formal denial of claim (form NF-10), your options are as follows:
- Take the insurer to court
- File a written complaint with us, the Department of Financial Services
- File for No-Fault arbitration with the American Arbitration Association(AAA)
Filing for Arbitration
Arbitration requests must be filed with the American Arbitration Association (even if a denial of claim form states that it should be filed with the New York State Department of Financial Services. Requests submitted to the Department will be returned).
- File online using the New York Insurance ADR Center online version of the Arbitration Request form (AR-1). Upload documents stored on your desktop. In addition, the successful submission of a case in ADR Center immediately generates a case number that will assist the filer with tracking the status of the case.
If your case was already submitted to the American Arbitration Association, you should contact them by calling Customer Support at (917) 438-1660 or by visiting the New York Insurance ADR Center.
To file for No-Fault arbitration by mail:
- If an insurer issued a denial of claim form (NF-10) applicable to any individual element of your No-Fault claim and you wish to arbitrate the basis of that denial, fully complete the information on the back of the denial and itemize all bills in dispute (including name of medical provider, amount of bill in dispute, and the date(s) the bill(s) were mailed to insurer) and attach copies of all bills listed. If lost wages are also in issue, complete the section of the grid applicable to lost wages. Complete and sign the affirmation on the back of the denial.
- If you are not in receipt of a denial of claim form, you can file for arbitration by fully completing and submitting Form AR-1, the No-Fault Arbitration Request Form. This form should be obtained directly from the website of the American Arbitration Association. Complete the four page form fully as outlined above (for an NF-10), and attach copies of all applicable documentation and bills in issue.
An applicant for No-Fault arbitration must submit all documents supporting their position along with their original request for arbitration. A copy of the complete submission must also be mailed to the insurer. Following this original submission of documents, no additional documents may be submitted by the applicant other than bills or claims for ongoing benefits.
Mail your completed No-Fault arbitration request to:
Providers and Assignment of Benefits (AOB)
If a medical provider files for arbitration as an assignee of the injured party, that provider must also include a copy of a completed Assignment of Benefits Form with the injured party's signature.
Whichever method is used to initiate the arbitration process, your filing must also include a $40.00 filing fee made payable to the American Arbitration Association. The AAA accepts checks, money orders, and credit cards as valid forms of payment.
Filers can opt to open a cash account to pay filing fees by submitting a check or authorizing a credit card payment and can add additional funds to an existing cash account via check or credit card payment to the AAA. To establish a cash account, login to the ADR Center and access the Payment Information tab in the My Account section of your user profile. You must submit a check or credit card authorization form to complete the process. If you need assistance in setting up a cash account, please contact the AAA.
If you have won a judgment in a No-Fault Arbitration, you should not normally have any difficulty in collecting from the respondent. If you have not received payment within 30 days of the date of mailing of the No-Fault arbitration award, we suggest that you follow-up with the respondent in writing to advise of the specific elements of the award which remain unpaid and outstanding. If you do not receive a timely response from the respondent, you can seek assistance from us, the Department of Financial Services.
If you choose to file a complaint with DFS, use our Consumer Complaint app. There is no fee required to file a complaint. Although the Department will attempt to resolve disputed claims, it cannot order or require an insurer to pay a disputed claim filed as a complaint.
The Department maintains some Frequently Asked Questions about No-Fault Insurance.