Policy Exhaustion and 3.15

Matter of DTR Country-Wide Ins. Co. v Refill Rx Pharm., Inc., 2023 NY Slip Op 00179 (1st Dept. 2023)

“Country-Wide was not precluded from raising the issue of policy exhaustion before the court, even if it was not before the arbitrators in the underlying arbitration (Matter of Ameriprise Ins. Co. at 564).

Country-Wide submitted an affidavit from its No-Fault Litigation/Arbitration supervisor, attesting that the instant claims file of Refill’s assignor, Ms. Rosas, reflects that the policy has been exhausted beyond its $50,000 limit. The affidavit also contains a ledger reflecting the dates that claims by various medical providers were paid, which exhausted Ms. Rosas’ policy. Thus, Country-Wide’s submissions showed that the policy was properly exhausted prior to the underlying arbitration (see 11 NYCRR 65-3.15).”


Again, the issue as herein presented is whether the insurance complied with 3.15. It appears that did happen in this case.

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