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.

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