Congratulations to Adam Post on two wins for our valued client, Everest National Insurance Company!
In the first case involving first-party reimbursement for medical services, a woman who applied for automobile insurance from Everest in January 2016 was involved in a motor vehicle accident in April 2016. It was determined that she misrepresented her place of residence on her insurance application in an apparent attempt to avoid a $933.00 premium increase. When Everest discovered the material misrepresentation, it voided the policy and issued a premium refund check that she subsequently cashed.
A surgical practice that rendered medical treatment to the woman following the accident sought reimbursement for its services, and later sued Everest when the claim was denied. Adam filed a motion for summary disposition, arguing that the policy was void ab initio and that there was no coverage in the absence of a valid insurance policy. After receiving Adam’s motion, the plaintiff voluntarily dismissed the case.
In a similar matter, a woman insured by Everest was involved in an auto accident in November 2014. She, too, made misrepresentations in her application by failing to list family members who resided with her. Had she indicated that her mother and 16-year-old son lived in the same household, the six-month premium would have increased substantially. Discovering the misrepresentation, Everest voided the policy and issued a check for the premium refund.
Seeking payment for diagnostic services rendered, a medical provider submitted a claim that Everest denied. The provider filed a lawsuit, but Adam again filed a motion summary disposition based on the absence of valid insurance coverage, which the court granted, dismissing the action.
Zausmer
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