Policy exhaustion arbitration-trial de novoAugust 13, 2014
Interboro v. Miriam Cantor, Index #: 601298/14 (Sup. Ct. Nassau Co. 2014)
Here, Defendant sought no-fault reimbursement before AAA in the amount of $10,888.33. Defendant was awarded $7,934.24. Defendant was paid out $5,228.18, the amount remaining on the policy. Plaintiff files a master arbitration demand. Defendant then asserts that bill was paid in full. Defendant changed his mind and the briefing schedule expired. So, Plaintiff filed a demand for a trial de novo asserting policy exhaustion and an alternative cause of action based upon the lack of medical necessity of the services.
The court plainly stated -without a priority of payment debate – that through paying the $5,228.18 (the remaining amount on the policy), Plaintiff’s obligation under the policy ceased.
Interesting procedural dynamic to say the least.