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Moore v. Metropolitan Life Insurance Company

Supreme Court, Special Term, New York County
Aug 21, 1972
75 Misc. 2d 168 (N.Y. Sup. Ct. 1972)

Opinion

August 21, 1972

Stephen R. Shestakofsky for plaintiff.

Friend, Post Hopkins ( John G. Pare and Edward T. Post of counsel), for defendant.


In this action upon a group health insurance policy it is not contested that plaintiff received treatment from a certified and registered psychologist. Plaintiff seeks reimbursement for this expense upon the basis of section 221 (subd. 5, par. [e]) of the Insurance Law, effective September 1, 1969, as amended July 6, 1971. Plaintiff further contends that the policy, in effect, is renewed each year and thus is modified by said section. The import of the section is that if a policy provides for treatment by a physician for emotional disorders, then registered, certified psychologists are also to be included.

Defendant's contention that its policy, issued in 1957, is one complete policy and thus unaffected by section 221 Ins. of the Insurance Law is rejected. "Where an insurer has the absolute right to terminate a policy on its anniversary date ( Western N Y Med. Plan v. Wikler, 8 A.D.2d 988) * * * each renewal of the policy is deemed the issuance of a new policy" ( Gladstone v. Metropolitan Life Ins. Co., 66 Misc.2d 656, 657).

Furthermore, defendant has failed to exclude specifically reimbursement for emotional or nervous disorders from its definition of illness or injury or covered medical expenses.

Accordingly, plaintiff's motion for summary judgment is granted.


Summaries of

Moore v. Metropolitan Life Insurance Company

Supreme Court, Special Term, New York County
Aug 21, 1972
75 Misc. 2d 168 (N.Y. Sup. Ct. 1972)
Case details for

Moore v. Metropolitan Life Insurance Company

Case Details

Full title:CYRIL H. MOORE, JR., on Behalf of Himself and All Other Similarly Situated…

Court:Supreme Court, Special Term, New York County

Date published: Aug 21, 1972

Citations

75 Misc. 2d 168 (N.Y. Sup. Ct. 1972)
346 N.Y.S.2d 298

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