Saturday, July 18, 2009

Insurer did not violate 93A when it relied on IME to deny PIP claim

Massachusetts Lawyers Weekly recently reported on the case of Genest v. Commerce Ins. Co., a Salem District Court case in which an insurer was held not to have violated Mass. Gen. Laws ch. 93A when it failed to pay PIP benefits.

I was unable to obtain a copy of the decision online, so I am relying on the Lawyer's Weekly summary.

The insurer initially denied the plaintiff's $250 claim for PIP benefits, in reliance on an independent medical evaluation report.

The court held that in so doing the insurer did not violate Mass. Gen. Laws ch. 93A, even though judgment eventually entered against the insurer.

The court said, "where an insurance carrier has grounded its denial of a claim upon a legitimate defense and thereafter simply determines to pay a claim (in this case a nominal claim) within thirty (30) days of when the benefits are due and payable (in this instance within thirty (30) days of entry of any judgment), the plaintiff shall not be entitled to G.L. Ch. 93A relief."

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