A major national insurer, represented by Goldberg Segalla partner Michael A. Hamilton and associate Andrew P. Carroll, members of the firm’s Global Insurance Services practice, won a dismissal with prejudice of breach of contract and bad faith claims in the Delaware County Court of Common Pleas.
The matter involved a dispute between a plaintiff-patient and a medical provider and its insurer. The plaintiff alleged that the medical provider made false representations about certain surgical insurance benefits that would be available to the plaintiff. After the plaintiff submitted a claim in connection with alleged complications from the surgery, the insurer denied coverage on the basis that the plaintiff never met the requisites for any potential recovery under the policy. The patient-plaintiff commenced an action against the medical provider and other co-defendants, including the insurer, bringing breach of contract and bad faith claims against our client.
Making an aggressive motion for judgment on the pleadings, Mike and Andrew argued that coverage for the procedure never existed, and therefore the plaintiff was not entitled to any benefits under the $1 million policy. The court agreed, dismissing the plaintiff’s breach of contract and bad faith claims against the insurer, affirming the absence of relevant coverage, and removing our client from the ongoing litigation.