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Acquista v. New York Life Insurance Company

Appellate Division of New York
730 N.Y.S.2d 272 (2001)


Facts

Acquista (plaintiff) is a physician specializing in internal and pulmonary medicine. In November 1995, Acquista became ill and was instructed by his treating physicians to avoid exposure to radiation. His illness caused him to continually suffer from easy fatigue, headaches, and muscle and joint pain. Acquista is insured under three disability insurance policies issued by New York Life Insurance Company (New York Life) (defendant). After delaying its decision on the merits of Acquista’s claim, New York Life denied insurance covered to Acquista under all three policies on the ground that Acquista can still perform some of “the substantial and material duties” of his regular job and therefore is not “totally disabled.” Acquista brought suit in New York state court against New York Life, alleging claims for breach of contract, bad faith and unfair practices, fraud and fraudulent misrepresentation, and negligent infliction of emotional distress. The trial court granted New York Life’s motion to dismiss all of Acquista’s claims except for his claim based upon the provision in his insurance policy for residual and partial disability benefits. Acquista appealed.

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Holding and Reasoning (Saxe, J.)

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Dissent (Andrias, J.)

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