I think that came out wrong.

Panasia Estates, Inc. v Hudson Ins. Co., 2009 NY Slip Op 09284 (App. Div., 1st, 2009)

Plaintiff is correct in arguing that the motion court erred by stating that consequential damages do not lie for breach of an insurance contract absent bad faith, since the determinative issue is whether such damages were “within the contemplation of the parties as the probable result of a breach at the time of or prior to contracting” (Bi-Economy Mkt., Inc. v Harleysville Ins. Co. of N.Y., 10 NY3d 187, 192 [2008] [internal quotation marks and citation omitted]; see Panasia Estates, Inc. v Hudson Ins. Co., 10 NY3d 200, 203 [2008]). However, the motion to amend the complaint should not have been granted since the breach of contract claim that plaintiff sought to add was duplicative of its existing claim for breach of the implied covenant of good faith (see Canstar v Jones Constr. Co., 212 AD2d 452, 453 [1995]). Furthermore, contrary to defendants’ contention, plaintiff’s claim for consequential damages in its cause of action for breach of the implied covenant of good faith was not insufficiently pled. The reference to such damages as “special” in Bi-Economy Mkt. (10 NY3d at 192) was not intended to establish a requirement of specificity in pleading.

In consumer complaints.

In semi-related news, an Ontario Judge awarded a plaintiff $25,00.00 because:

Harris accused the insurer of “creating an adversarial relationship that was likely to create mental distress,” noted that the “insurer’s approach to the Plaintiff was counter-productive to the well being of the Plaintiff,” and concluded that “the change in her emotional and psychological conduct has come about through her relationship with the Defendant insurance company, keeping in mind that the Plaintiff has had 21 denials of 16 separate benefits over a three year period.”

Read more HERE.

I bumped this up because of the interest it generated–there has been a ridiculous amount of comments on this post

Because a lot of people have been trying to look at the complaint the bandwidth has been exceeded. This means two things: (1) Calm the hell down and stop trying to download it every five seconds and (2) After you’ve calmed down, wait a bit before trying to download it or try it at odd hours.

Recently a few medical providers filed a 225 page complaint against State Farm, Autoone, General Assurance, One Beacon, NICB, The Superintendent of Insurance, John Doe Insurance Companies, and some law firms in relation to those entities’ handling of no-fault claims. Plaintiffs are also asking to be certified as a class. Venue is New York County Supreme Court.

The gist of the complaint is:

The Insurance Company Defendants, the NICB and Enforcer Counsel have worked together to defraud EIPs and their medical provider assignees by engaging in wholesale bad faith in violation of a plethora of New York State Laws and have hijacked law enforcement into indicting and arresting individuals and corporate entities. All of the above was and is being perpetrated to increase profits at the expense of New York State Citizens.

The allegations include, but are not limited to:

1. That the named insurance companies’ SIU investigators fail to meet the statutory requirements for qualifications in order to be a investigator; the investigator’s fail to satisfy the minimum requirements.

2. State Farm Claims dept. has preset monetary quota as to the amounts that can be paid out and has incentives for Claims and SIU to keep payments beneath that quota.

3. That several of the insurance companies keep inadequate reserves and have policies designed to prevent payment of proper claims to remedy the inadequacy.

3. That law firms that act as SIU “enforcer counsel” act in concert with SIU to coerce, intimidate, and otherwise do things that are not nice, to provide “ammunition” to Claims.

4. Those law firms submit affidavits, documents, and other things that they know are illegal.

5. That the NICB is not a governmental agency, is wholly funded by the insurance companies, and needs to “Kill Claims” in order to keep their insurance company membership. And in doing so, uses illegal and unethical means.

6. That Operation BORIS was an illegal investigation, funded by “donations” provided by the NICB, who acted as a intermediary between State Farm and the DA’s office–that this was done as a pretext for State Farm to unfairly deny claims.

7. That Law Firms acted as “hub[s] through which false/bad faith information obtained through its own nefarious “investigations” and the Insurance Company Defendants’ “investigations” is disseminated to other Defendant Insurance Companies (s/h/a “John Doe Insurance Companies”), in violation of the Donnelly Act.”

8. That the insurance companies are using their SIU departments to intimidate through illegal means in order to keep claims from being paid.

Plaintiff is seeking wholly declaratory relief (not looking for monetary sum).

Look for more posts later.

To see the Complaint, click on the link above. Thanks to Roy Mura of CoverageCounsel for hosting the complaint. Mr. Mura has since decided not to host the complaint, which he is entitled to do. He has posted an explanation on his blog and I encourage everyone to have a look at it to see another perspective on this lawsuit.

I am hosting the complaint now. If people don’t read the complaint, they can’t form an opinion. Read it and come to your own conclusion–you might wind up agreeing with Mr. Mura; you might not.

Edit: Mr. Mura has updated his post after reviewing the complaint in its entirety.