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1. Click ‘Get Form’ to open the New York Motor Vehicle No-Fault Insurance Law Arbitration Request Form in the editor.
2. Begin by filling out Part 1, 'Parties in Dispute.' Enter your last name, first name, and address. Indicate if benefits were assigned to a provider and provide the date of the accident.
3. Continue with details about the injured person and policyholder. Include their names, addresses, policy number, and insurer information.
4. In Part 2, 'Requests for Special Handling,' select your preferences for arbitration handling. Indicate if you want written submissions or a telephone hearing.
5. Move to Part 3, 'Claim(s) in Dispute.' Check all applicable claims and provide detailed amounts for medical expenses, other necessary expenses, interest, death benefits, loss of earnings, and attorney’s fees.
6. Ensure all required documentation is attached as exhibits. Review your entries for accuracy before submitting.
7. Finally, follow the instructions on how to file by mailing the completed form along with attachments and payment to the American Arbitration Association.

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