American Arbitration Association No-Fault/Accident Claims - Award of Dispute Resolution Professional

Sep 15, 2026

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Award of dispute resolution professional issued under American Arbitration Association no-fault dispute rules in New Jersey. The decision addresses sufficiency of billing submitted by a medical care provider to the respondent insurer for services rendered to an injured person after a March 21, 2001 automobile accident, including arguments on timeliness and the effect of filing a demand for arbitration. The award includes findings on flawed supporting evidence and concludes that the claimant is the prevailing party, awarding adjusted attorney’s fees and costs while medical expense benefits are not in issue.

LanguageEnglish

CategoryLetters

FormatPDF

Pages4

Reading Time2 min

AccessFree to download

Award of Dispute Resolution Professional

Parties, hearing, and procedural status

Findings of fact and conclusions of law

Medical expense benefits

Attorney’s fees and costs

CASE NO. 18 Z 600 20268 1 2 A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS | In the Matter of the Arbitration between
(Claimant)
v.
MOTOR CLUB OF AMERICA INSURANCE COMPANY (Respondent) | AAA CASE NO.: 18 Z 600 20268 1
INS. CO. CLAIMS NO.: 75178
DRP NAME: Michael F. Carnevale II
NATURE OF DISPUTE: Sufficiency of Billing | | --- | --- | AWARD OF DISPUTE RESOLUTION PROFESSIONAL I, THE UNDERSIGNED DISPUTE RESOLUTION PROFESSIONAL (DRP), designated by the American Arbitration Association under the Rules for the Arbitration of No-Fault Disputes in the State of New Jersey, adopted pursuant to the 1998 New Jersey “Automobile Insurance Cost Reduction Act” as governed by N.J.S.A. 39:6A-5, et. seq., and, I have been duly sworn and have considered such proofs and allegations as were submitted by the Parties. The Award is DETERMINED as follows: Injured Person(s) hereinafter referred to as: MV. 1. ORAL HEARING held on April 16, 2002. 2. ALL PARTIES APPEARED at the oral hearing(s) . NO ONE appeared telephonically. 3. Claims in the Demand for Arbitration were NOT AMENDED at the oral hearing (Amendments, if any, set forth below) . STIPULATIONS were not made by the parties regarding the issues to be determined (Stipulations, if any, set forth below) . 4. FINDINGS OF FACTS AND CONCLUSIONS OF LAW: Claimant is a medical care provider who brings this action on assignment from MV who insured by respondent at the time of the March 21, 2001 automobile accident. The issue in this AICRA case is the sufficiency of billing by claimant to respondent for services rendered by claimant to MV, and attorney's fees and costs. In considering this matter I have reviewed the submissions of the parties, which include bills and claimant's September 13, 2001 demand for payment letter to respondent, CASE NO. 18 Z 600 20268 1 3 submitted by claimant; and EOBs, payment ledgers and payment print-outs and the certification of respondent's representative Dolores McAllister, submitted by respondent. I have also considered the arguments of counsel, advanced at the hearing and in writing. Respondent asserts that it did not timely receive bills from claimant with respect to two sets of dates of treatment. Claimant contends that bills were timely submitted, and some of them simply were not acted upon until after the filing of the demand for arbitration. The evidence submitted is clear, however, in that the bills in question have been paid as of the rendering of this award, but subsequent to the filing of the demand for arbitration. The issue of attorney's fees and costs remain. All of the evidence before me is, in one way or another, flawed. Claimant presents bills for services which identify respondent as the responsible automobile insurance carrier, but do not state an address. Claimant's letter of September 13, 2001, purportedly sent prior to the filing of the demand for arbitration, is a form letter which identifies claimant and date of accident, but does not identify which bills were alleged to be outstanding. Most significantly, however, the bill is addressed to respondent at an incorrect address. Respondent relies on certification of Dolores McAllister, which states that any bills submitted by or on behalf of MV to respondent had in fact been paid, subject to appropriate reductions. Although credible on its face, this generic certification is not, however, dated and does not make reference to particular bills, dates of service, dates received or dates of payments, therby reducing its probative value in this particular case. Respondent also submits ledger sheets and printouts of payments, which indicate that respondent did receive some bills at least from claimant and paid them no later than November 2001, prior to the filing of the demand for arbitration. Respondent is correct in that claimant has submitted no certification or other evidence to support its contentions. Claimant

FAQs

What issue did the award address in this arbitration?

The award addressed the sufficiency of billing by the claimant to the respondent for services rendered to the injured person, including attorney’s fees and costs.

Did the parties amend their claims at the oral hearing?

No. Claims in the demand for arbitration were not amended at the oral hearing, and no stipulations were made regarding the issues to be determined.

Why did the claimant receive attorney’s fees and costs?

The award found the claimant to be the prevailing party because the bills were paid after the demand for arbitration, and it concluded that but for filing the demand, the bills would not have been processed. Attorney’s fees were set at a reduced reasonable amount.

Sep 15, 2026

Upload by Rhys