Is New York a no-fault insurance state?

Yes. New York is a no-fault state, meaning your own auto insurance pays for medical bills and lost wages after a covered accident, regardless of who caused it, up to the policy's PIP limit.

What is AAA no-fault arbitration in New York?

AAA arbitration is the mandatory forum for disputing denied or underpaid New York no-fault claims. A neutral arbitrator reviews the file and issues a binding award, typically faster and cheaper than court.

Who do you work with?

We support NYC law firms, medical providers, billing companies, and individual claimants on no-fault arbitration files, IME and peer review rebuttals, fee-schedule defenses, and Workers' Compensation coordination — in English and French.

May 2026 — NY No-Fault Carrier Defense & Denial Report

Top Carrier Defenses

Lack of medical necessity (peer review)

31%

Heavy use of templated peer reviews citing outdated ACR criteria.

IME no-show / cut-off

22%

Notice defects remain the leading reason these defenses are overturned.

Defense Rankings & Outcome Data

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Top Carrier Defenses (Full)

Lack of medical necessity (peer review)

31%

Heavy use of templated peer reviews citing outdated ACR criteria.

IME no-show / cut-off

22%

Notice defects remain the leading reason these defenses are overturned.

Fee-schedule reductions

18%

Most reductions resolve pre-hearing once a code-by-code reconciliation is filed.

Late billing under 45-day rule

12%

Strong reasonable-justification arguments restored payment in the majority of files we tracked.

EUO non-appearance

Carrier mailing chains continue to be the weak link.

Top Verification Defects

15-day initial response missed

34%

Most common defect in plaintiff-side files; tracking alerts eliminate it.

30-day follow-up missing

27%

Carriers often allege non-receipt; certificates of mailing close this gap.

Incomplete document production

21%

Partial responses still trigger non-cooperation defenses.

120-day rule overrun

11%

Most overruns trace back to inbox triage failures, not legal issues.

Address-of-record errors

Notices sent to outdated provider addresses remain highly reversible.

Top Denial Reasons

Medical necessity (peer review)

29%

Rebuttable with treating-provider affidavits and current literature.

IME findings

24%

Often rebuttable on procedural notice defects before reaching the merits.

Fee-schedule violation

19%

Reconciliation is the single highest-ROI response.

Lack of coverage / staged accident

10%

Heavier evidentiary lift; requires policy-side discovery.

Workers' Comp primary

Coordination of benefits errors continue to drive avoidable denials.

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May 2026 — NY No-Fault Carrier Defense & Denial Report

Top Carrier Defenses

Lack of medical necessity (peer review)

IME no-show / cut-off

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