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ADIPIETRO v. CHUBB LIFE AMERICAN

May 7, 1990

GRACE C. ADIPIETRO, PLAINTIFF,
v.
CHUBB LIFE AMERICAN AND THE COLONIAL LIFE INSURANCE COMPANY OF AMERICA, DEFENDANTS.



The opinion of the court was delivered by: McLAUGHLIN, District Judge.

MEMORANDUM AND ORDER

Plaintiff, Grace C. Adipietro, is a New York citizen. Defendant Colonial Life Insurance Company of America ("Colonial") is an insurance company incorporated under the laws of New Jersey with its principal place of business in New Jersey.*fn1 This Court's jurisdiction is based upon diversity of citizenship. 28 U.S.C. § 1331.

FACTS

On September 1, 1982 Loriann Adipietro, plaintiff's daughter, suffered severe injuries which left her comatose for three and one-half months. Loriann was hospitalized from September 1, 1982 until November 1983. Thererafter, Loriann received therapy at Children's Specialized Hospital in Mountainside, New Jesey on an out-patient basis until May 1984.

During this therapy, Loriann's physician recommended that she continue her treatment at a facility closer to her home. To that end, Loriann sought and gained admission to the New York University Medical Center Head Trauma Rehabilitation Program (the "Program") beginning in fall 1984.

At the time Loriann entered the Program, her mother, plaintiff Grace C. Adipietro, was employed full-time by TDK Electronics Corp. According to plaintiff, all full-time employees of TDK were entitled to family medical benefits under Colonial Group Policy Number 305377-000 (the "Policy").

Apparently, plaintiff sought assurance from Colonial that she would be reimbursed for Program expenses incurred by Loriann. On approximately June 21, 1984, Colonial informed plaintiff that Program expenses would not be covered under the Policy.

In December 1984 plaintiff brought an action in this Court captioned Grace C. Adipietro v. The Chubb Life American and the Colonial Life Insurance Company of America, 84 CV 4873 (the "1984 Action"). Plaintiff brought the 1984 Action to recover compensatory and punitive damages for Colonial's allegedly "arbitrary" denial of benefits, and for a judgment declaring that the Policy obligated Colonial to "pay for all cognitive therapy prescribed up to the present time . . ." (Affidavit In Support of Motion ("Aff. In Supp."), Exh. A at 7).

On October 1, 1985 the parties entered into a stipulation settling the 1984 Action (the "Stipulation"). The present controversy centers on the Stipulation, which provides in part that:

  1.  Defendant [Colonial] agrees to reimburse
      plaintiff for the cost of plaintiff's daughter
      Loriann's participation in the [Program]
      as described in . . . Exhibit 1.
  2.  Reimbursement shall be for the fees actually
      incurred and limited to the amount of
      $24,910.00 as set forth in Exhibit 1.
  3.  Plaintiff agrees to accept the foregoing
      reimbursement in full satisfaction of all
      plaintiff's claims set forth in the complaint
      and the [1984 Action] is discontinued with
      prejudice . . ., and
  4.  [E]vidence of this . . . settlement shall
      not
      be admissible in any future litigation
      pertaining to any future treatment
      programs for ...

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