Hospital for Joint Diseases v. Allstate Insurance Company
| Decision Date | 01 August 2005 |
| Docket Number | 2004-09003. |
| Citation | 800 N.Y.S.2d 190,2005 NY Slip Op 06192,21 A.D.3d 348 |
| Parties | HOSPITAL FOR JOINT DISEASES, Appellant, v. ALLSTATE INSURANCE COMPANY, Respondent. |
| Court | New York Supreme Court — Appellate Division |
Ordered that the order is modified, on the law, by deleting the provisions thereof granting those branches of the cross motion which were for summary judgment dismissing the first and second causes of action and denying that branch of the motion which was for summary judgment on the first cause of action and substituting therefor provisions denying those branches of the cross motion, reinstating the first and second causes of action, and granting that branch of the motion which was for summary judgment on the first cause of action; as so modified, the order is affirmed insofar as appealed from, without costs or disbursements.
The Supreme Court erred in concluding that the plaintiff lacked standing to bring the action absent proof of a valid assignment from each claimant. The hospital facility forms submitted on behalf of the respective patients indicated that the signature of each patient/assignor was "on file." There was no allegation or evidence that the defendant timely objected to the completeness of the forms or sought verification of the assignments as required by 11 NYCRR 65.15 (d). Accordingly, the defendant waived any defenses based thereon (see Nyack Hosp. v Metropolitan Prop. & Cas. Ins. Co., 16 AD3d 564 [2005]; New York Hosp. Med. Ctr. of Queens v. New York Cent. Mut. Fire Ins. Co., 8 AD3d 640, 641 [2004]; New York Hosp. Med. Ctr. of Queens v. AIU Ins. Co., 8 AD3d 456 [2004]).
With regard to the first cause of action, after the plaintiff made out a prima facie case for summary judgment, the defendant failed to raise a triable issue of fact as to whether the insured's 2002 medical expenses "were for injuries for which expenses for treatment had not been submitted to it within one year of [his] accident" (Stanavich v. General Acc. Ins. Co. of Am., 229 AD2d 872, 873 [1996]; see 11 NYCRR 65.15 [o] [1] [iii]). In any event, the defendant's failure to assert this statutory-exclusion defense within 30...
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Ap Orthopedics & Rehab. v. Allstate Ins. Co.
...treatment for that injury had been submitted to the insurer within the one-year period.” Id. In Hospital for Joint Diseases v. Allstate Ins. Co., 21 A.D.3d 348, 800 N.Y.S.2d 190 (2d Dept.2005), the Second Department further spelled out how this defense could be raised, albeit through a moti......
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Hospital for Joint Diseases v. Travelers
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