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KENAVAN v. EMPIRE BLUE CROSS

248 A.D.2d 42 (1998)

677 N.Y.S.2d 560

Robert Kenavan et al., Plaintiffs, and Irving Schmookler, Respondent, v. Empire Blue Cross and Blue Shield, Appellant

Appellate Division of the Supreme Court of the State of New York, First Department.

September 17, 1998

Attorney(s) appearing for the Case

Whitney North Seymour, Jr., of counsel (Craig A. Landy and Peter James Clines on the brief; Landy & Seymour, attorneys), for respondent.

Howard S. Wolfson of counsel (Robert A. Bicks, Patricia Anne Kuhn and Galina A. Krasilovsky on the brief; Whitman Breed Abbott & Morgan, L. L. P., attorneys), for appellant.

MILONAS, J. P., WALLACH and SAXE, JJ., concur.

NARDELLI, J.

Plaintiffs paid premiums for Medigap insurance (i.e., coverage for the 20% difference the patient is liable for when a doctor does not accept assignments from Medicare). In so doing, they believed that they would be covered for any difference in the amount paid by Medicare to the doctor and the reasonable amount billed. Defendant Empire failed to live up to its obligations under the policies and...

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