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Massachusetts law appliesJuly 18, 2016

Renelique v Metlife Auto & Home, 2016 NY Slip Op 51075(U)(App. Term 2d Dept. 2016)

“Insofar as is relevant to the present case, while Massachusetts law provides for payment of personal injury protection (PIP) benefits up to $8,000 for one person in any one accident (Mass Gen Laws Ann ch 90, § 34A), it further provides that, notwithstanding the $8,000 limitation, payment of PIP benefits in excess of $2,000 is not required where “such expenses have been or will be compensated, paid or indemnified pursuant to,” among other things, a health insurance policy (Mass Gen Laws Ann ch 90, § 34A; see Dominguez v Liberty Mut. Ins. Co., 429 Mass 112, 112-113 [1999]). Furthermore, an injured party is required to cooperate in enabling the insurer to obtain “needed information to assist in determining the amounts due. Noncooperation of an injured party shall be a defense to the insurer in any suit for benefits authorized by this section” (Mass Gen Laws Ann ch 90, § 34M).

Defendant established, prima facie, through its no-fault litigation representative, that plaintiff’s assignor had failed to comply with the terms of the applicable insurance policy by failing to submit a health insurance affidavit stating whether he was covered by a health insurance plan. The affirmation of plaintiff’s counsel and the affidavit of plaintiff’s owner were insufficient to raise a triable issue of fact in opposition. We note that plaintiff’s remaining arguments on appeal are unpreserved for appellate review.”

I would have to assume the motor vehicle accident did not occur in New York or New Jersey, which have deemers well above and beyond the $8,000/$10,000 in benefits that the Massachusetts policy in question contains.  It also goes to show that in these states with lower policy limits and probably r and c fee schedules, the most expedient way to handle these claims is to exhaust the policy and to wash ones hands from these claims.

 

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