Coverage Pointers - Volume 0, No. 0

10/21/03          IN THE MATTER OF MEDICAL SOCIETY v SERIO

New York State Court of Appeals

New York High Court Upholds Major Anti-Fraud Amendments to No-Fault Regulations

Ending a four year court battle, the New York Court of Appeals has affirmed lower court decisions sustaining substantially revised No-Fault regulations adopted by the Superintendent of Insurance designed to combat fraud. The Court recognized that the Superintendent determined that the revised regulations are the most effective means of advancing the legislative intent of providing prompt payment of benefits as the loss is incurred, while reducing rampant abuse. That being so, this Court decided it would not substitute its judgment for that of the Superintendent, but may determine only whether the Superintendent acted within the scope of his lawfully delegated authority. Since the Superintendent’s determination was neither irrational nor unreasonable, neither arbitrary nor capricious, the regulations must be upheld.