New York Consolidated Laws

N.Y. Insurance Law § 5106 (2026)

Fair claims settlement

✓ current as of May 2026

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§ 5106. Fair claims settlement. (a) Payments of first party benefits
and additional first party benefits shall be made as the loss is
incurred.  Such benefits are overdue if not paid within thirty days
after the claimant supplies proof of the fact and amount of loss
sustained. If proof is not supplied as to the entire claim, the amount
which is supported by proof is overdue if not paid within thirty days
after such proof is supplied. All overdue payments shall bear interest
at the rate of two percent per month. If a valid claim or portion was
overdue, the claimant shall also be entitled to recover his attorney's
reasonable fee, for services necessarily performed in connection with
securing payment of the overdue claim, subject to limitations
promulgated by the superintendent in regulations.
  (b) Every insurer shall provide a claimant with the option of
submitting any dispute involving the insurer's liability to pay first
party benefits, or additional first party benefits, the amount thereof
or any other matter which may arise pursuant to subsection (a) of this
section to arbitration pursuant to simplified procedures to be
promulgated or approved by the superintendent. Such simplified
procedures shall include an expedited eligibility hearing option, when
required, to designate the insurer for first party benefits pursuant to
subsection (d) of this section. The expedited eligibility hearing option
shall be a forum for eligibility disputes only, and shall not include
the submission of any particular bill, payment or claim for any specific
benefit for adjudication, nor shall it consider any other defense to
payment.
  (c) An award by an arbitrator shall be binding except where vacated or
modified by a master arbitrator in accordance with simplified procedures
to be promulgated or approved by the superintendent. The grounds for
vacating or modifying an arbitrator's award by a master arbitrator shall
not be limited to those grounds for review set forth in article
seventy-five of the civil practice law and rules. The award of a master
arbitrator shall be binding except for the grounds for review set forth
in article seventy-five of the civil practice law and rules, and
provided further that where the amount of such master arbitrator's award
is five thousand dollars or greater, exclusive of interest and
attorney's fees, the insurer or the claimant may institute a court
action to adjudicate the dispute de novo.
  (d) (1) Except as provided in paragraph two of this subsection, where
there is reasonable belief more than one insurer would be the source of
first party benefits, the insurers may agree among themselves, if there
is a valid basis therefor, that one of them will accept and pay the
claim initially. If there is no such agreement, then the first insurer
to whom notice of claim is given shall be responsible for payment. Any
such dispute shall be resolved in accordance with the arbitration
procedures established pursuant to section five thousand one hundred
five of this article and regulations as promulgated by the
superintendent, and any insurer paying first-party benefits shall be
reimbursed by other insurers for their proportionate share of the costs
of the claim and the allocated expenses of processing the claim, in
accordance with the provisions entitled "other coverage" contained in
regulation and the provisions entitled "other sources of first-party
benefits" contained in regulation. If there is no such insurer and the
motor vehicle accident occurs in this state, then an applicant who is a
qualified person as defined in article fifty-two of this chapter shall
institute the claim against the motor vehicle accident indemnification
corporation.
  (2) A group policy issued pursuant to section three thousand four
hundred fifty-five or three thousand four hundred fifty-eight of this
chapter shall provide first party benefits when a dispute exists as to
whether a driver was using or operating a motor vehicle in connection
with a transportation network company or peer-to-peer car sharing
program when loss, damage, injury, or death occurs. A transportation
network company or peer-to-peer car sharing program administrator shall
notify the insurer that issued the owner's policy of liability insurance
of the dispute within ten business days of becoming aware that the
dispute exists. When there is a dispute, the group insurer liable for
the payment of first party benefits under a group policy shall have the
right to recover the amount paid from the driver's insurer or in the
case of a peer-to-peer car sharing program, the shared vehicle owner's
insurer to the extent that the driver would have been liable to pay
damages in an action at law.
  (e) With respect to an action for serious personal injury permissible
under section five thousand one hundred four of this article, an award
or decision of an arbitrator or master arbitrator or that is court
rendered pursuant to subsection (c) of this section seeking no-fault
reimbursement by or for medical providers, shall not be given collateral
estoppel effect in any action or proceeding arising out of the same
occurrence and shall not be admissible in any action or proceeding in
actions seeking damages for bodily injuries, pain suffering, medical
care and loss of wages as evidence of any facts.

Notes of Decisions

Cited in 502 cases (78 in the last 5 years), 1985–2026 · leading case: Viviane Etienne Med. Care v. Country-Wide Ins., 35 N.E.3d 451 (NY 2015).

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Viviane Etienne Med. Care v. Country-Wide Ins., 35 N.E.3d 451 (NY 2015). · cites it 19× “5 [b]) and within 30 days after receiving the verification of treatment form, the insurer must pay or deny the claim (see Insurance Law § 5106 [a]; 11 NYCRR 65–3.8 [c]).”

Presbyterian Hosp. v. Maryland Cas. Co., 683 N.E.2d 1 (NY 1997). · cites it 30× “15 [g] [3]; Insurance Law § 5106 [a]). Supreme Court granted Presbyterian's motion for summary judgment, awarding approximately $26,000 in no-fault benefits, statutory interest and attorney's fees.”

Cent. Gen. Hosp. v. Chubb Grp. of Ins. Companies, 681 N.E.2d 413 (NY 1997). · cites it 14× “This appeal stems from a lawsuit by Central General Hospital, pursuant to Insurance Law § 5106 (a), to recover no-fault billings from Chubb Group of Insurance Companies for medical services rendered to an allegedly injured motorist.”

Med. Soc'y v. Serio, 800 N.E.2d 728 (NY 2003). · cites it 9× “Under the no-fault system, payments of benefits “shall be made as the loss is incurred” (Insurance Law § 5106 [a]). The primary aims of this new system were to ensure prompt compensation for losses incurred by accident victims without regard to fault or negligence, to reduce the…”

Matter of B.Z. Chiropractic, P.C. v. Allstate Ins. Co., 2021 NY Slip Op 04484 (N.Y. App. Div. 2021). · cites it 10× “Apparently not placed before the Civil Court or the Appellate Term was any issue about the rate at which any such interest should be calculated, though in its submission, BZ incidentally mentioned that the rate was 2% per month as mandated by Insurance Law § 5106 and former 11…”

In Re the Arbitration Between Greenberg & Ryder Truck Rental, Inc., 517 N.E.2d 879 (NY 1987). · cites it 6× “In this no-fault controversy, we must delineate the scope and nature of the judicial function in an "action to adjudicate the dispute de novo” pursuant to Insurance Law § 5106 (c) after the benefits phase of a bifurcated arbitration procedure is completed (see, 11 NYCRR 65.”

Shady Grove Orthopedic Assocs., P.A. v. Allstate Ins., 549 F.3d 137 (2d Cir. 2008). · cites it 7× “Shady Grove sought damages in excess of $5,000,000 on behalf of a putative class of all individuals to whom Allstate owes interest under N.Y. Ins. Law § 5106 (a). See Shady Grove Orthopedic Assocs.”

East Acupuncture, P.C. v. Allstate Ins., 61 A.D.3d 202 (N.Y. App. Div. 2009). · cites it 7× “Contemporaneously therewith, by notice of motion dated July 19, 2004, East Acupuncture moved for summary judgment in its favor for the amount of the principal sums demanded in the complaint plus statutory interest, arguing that Allstate had failed to establish that it paid or…”

Shady Grove Orthopedic Assocs. v. Allstate Ins. Co., 466 F. Supp. 2d 467 (E.D.N.Y 2006). · cites it 11× “”) and assert claims against Allstate for breach of contract, bad faith breach of contract, and violation of N.Y. Ins. Law § 5106 . On behalf of a putative class, plaintiffs seek damages in excess of $5,000,000 and assert diversity jurisdiction under 28 U.”

In re the Arbitration between Falzone & New York Mut. Fire Ins., 939 N.E.2d 1197 (NY 2010). · cites it 3× “*536 Insurance Law § 5106, titled “Fair claims settlement,” was designed for its titled purpose: to provide a forum where persons sustaining injuries in auto accidents could quickly adjudicate whether or not their no-fault carriers would pay their claims (see Roggio v Nationwide…”

Dermatossian v. New York City Transit Auth., 492 N.E.2d 1200 (NY 1986). · cites it 3× “(Insurance Law § 5106 [a].) Plaintiff’s argument to the contrary is based on a misconception of an insurer’s obligations under the No-Fault Law and, particularly, when and how an insurer must pay first-party benefits to a "covered person”.”

State Farm Mut. Auto. Ins. v. James M. Liguori, M.D., P.C., 589 F. Supp. 2d 221 (E.D.N.Y 2008). · cites it 6× “Liguori”) (collectively, “defendants”), related to alleged fraudulent claims for payment under New York State’s No-Fault Insurance Laws ( N.Y. Ins. Law § 5106 ). Defendants move to dismiss the complaint pursuant to Federal Rule of Civil Procedure 12(b)(6) for failure to state a…”

Show all 502 citing cases →

— N.Y. Insurance Law § 5106(a) — 17 cases

Matter of B.Z. Chiropractic, P.C. v. Allstate Ins. Co., 2021 NY Slip Op 04484 (N.Y. App. Div. 2021). “Apparently not placed before the Civil Court or the Appellate Term was any issue about the rate at which any such interest should be calculated, though in its submission, BZ incidentally mentioned that the rate was 2% per month as mandated by Insurance Law § 5106 and former 11…”

Burt Rigid Box Inc. v. Travelers Prop. Cas. Corp., 126 F. Supp. 2d 596 (W.D.N.Y. 2001).

Am. Tr. Ins. Co. v. Comfort Choice Chiropractic, P.C., 2025 NY Slip Op 01337 (N.Y. App. Div. 2025).

East Coast Acupuncture, P.C. v. Hereford Ins., 51 Misc. 3d 441 (N.Y. City Civ. Ct. 2016).

Tolley v. Am. Transit Ins., 638 F. Supp. 1191 (S.D.N.Y. 1986).

— N.Y. Insurance Law § 5106(b) — 3 cases

Sky Med. Supply Inc. v. SCS Support Claims Servs., Inc., 17 F. Supp. 3d 207 (E.D.N.Y 2014).

Goodkin v. United States, 600 F. Supp. 1459 (E.D.N.Y 1985).

State Farm Mut. Auto. Ins. Co., State Farm Indem. Co., State Farm Guar. Ins. Co., & State Farm Fire & Cas. Co. v. Emuna Inc., d/b/a Navar Pharmacy (E.D.N.Y 2026).

— N.Y. Insurance Law § 5106(c) — 16 cases

Am. Tr. Ins. Co. v. Comfort Choice Chiropractic, P.C., 2025 NY Slip Op 01337 (N.Y. App. Div. 2025).

Lancer Ins. Co. v. Fishkin, 2022 NY Slip Op 06921 (N.Y. App. Div. 2022).

Allstate Ins. Co. v. Kapeleris, 2020 NY Slip Op 2645 (N.Y. App. Div. 2020).

Unitrin Advantage Ins. Co. v. Cohen & Kramer M.D., P.C., 2020 NY Slip Op 06474 (N.Y. App. Div. 2020).

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