The Court of Appeals saw things differently. In a 6-1 decision, the majority said insurers cannot unilaterally decide that a provider has committed misconduct serious enough to withhold payment. That authority belongs to state regulators, specifically New York’s Board of Regents, which oversees professional licensing and discipline. Justice Rivera explained the concern: if insurers could deny claims whenever they suspected professional misconduct, they could delay payments based on mere allegations. New York’s no-fault system, enacted in 1973, was designed to get money to accident victims quickly, without litigation delays. Giving insurers power to make unilateral misconduct determinations would defeat that purpose.