Bertucci v. 21st Century Insurance, 602913/15, NYLJ 1202751140023
The insured/injured, was a Pennsylvania resident who got into an accident in Suffolk County New York sued the carrier, bypassing the provider/assignment process, for disclaiming coverage and subsequent payment of his medical bills through No Fault. Suit was based on negligence, breach of contract and punitive damages. Plaintiff asserted that the carrier was negligent in communicating the disclaimer to the medical provider who then refused to further continue treating the injured plaintiff and thereby complicate and delay his recovery from the accident.
The Court dismissed the action finding no negligence on the part of the insurer based upon its “communications” with medical providers. The Court also found no duty or breach thereof on the part of the carrier in terms of negligence. Lastly, the Court ruled that punitive damages are were not recoverable as they are only recoverable “if necessary to vindicate a public right,” not to remedy a potential private wrong.
I guess challenging the denials through arbitration would have been futile.