Presbyterian Hosp. in City of New York v. Liberty Mut. Ins. Co.

Decision Date19 June 1995
Citation216 A.D.2d 448,628 N.Y.S.2d 396
PartiesPRESBYTERIAN HOSPITAL IN the CITY OF NEW YORK, As Assignee of Kenneth Mandel, Appellant, v. LIBERTY MUTUAL INSURANCE COMPANY, Respondent.
CourtNew York Supreme Court — Appellate Division

Joseph Henig, P.C., Bellmore, for appellant.

Robert Trestman, Plainview, for respondent.

Before SULLIVAN, J.P., and MILLER, PIZZUTO and FRIEDMANN, JJ.

MEMORANDUM BY THE COURT.

In an action pursuant to Insurance Law § 5106(a) to recover the payment of a hospital no-fault billing, the plaintiff appeals from an order of the Supreme Court, Nassau County (Segal, J.), dated July 5, 1994, which denied its motion for summary judgment and granted the defendant's cross motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with costs.

The plaintiff's assignor exhausted his $100,000 no-fault policy limits and received formal notice of this exhaustion from the defendant some six months before the hospitalization at issue in this case. The plaintiff contends that the defendant's denial of the instant claim was untimely and, therefore, the defendant was precluded from raising the exhaustion of the policy limits as a defense. However, where, as here, an insurer has paid the full monetary limits set forth in the policy, its duties under the contract of insurance cease (see, Champagne v. State Farm Mut. Auto. Ins. Co., 185 A.D.2d 835, 837, 586 N.Y.S.2d 813). The defendant's tardiness in issuing its denial of claim could not thereafter create a new policy or additional coverage in excess of the amount contracted for (see, e.g., Zappone v. Home Ins. Co., 55 N.Y.2d 131, 447 N.Y.S.2d 911, 432 N.E.2d 783; Albert J. Schiff Assocs. v. Flack, 51 N.Y.2d 692, 435 N.Y.S.2d 972, 417 N.E.2d 84; Employers Ins. of Wausau v. County of Nassau, 141 A.D.2d 496, 530 N.Y.S.2d 157).

We have considered the plaintiff's remaining contentions and find them to be without merit.

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    • United States
    • U.S. District Court — Southern District of New York
    • February 19, 2004
    ...a new policy or additional coverage in excess of the amount contracted for. Presbyterian Hospital in the City of New York v. Liberty Mutual Insurance Co., 216 A.D.2d 448, 448, 628 N.Y.S.2d 396, 397 (2d Dep't 1995) (citations omitted); see also Presbyterian Hospital in the City of New York v......
  • Country-Wide Ins. Co. v. AMSC, LLC
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    ...272 A.D.2d 245 [1st Dept. 2000]), and while such defense is not subject to preclusion (see, Presbyterian Hosp, v Liberty Mut. Ins. Co., 216 A.D.2d 448 [2nd Dept. 1995]) and has been successfully advanced in confirmation proceedings initiated under Article 75 of the CPLR (see, Countrywide In......
  • Alleviation Med. Servs., P.C. v. Allstate Ins. Co.
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    • February 24, 2021
    ...the policy limits, "its duties under the contract of insurance cease" ( Presbyterian Hosp. in City of N.Y. v. Liberty Mut. Ins. Co., 216 A.D.2d 448, 448, 628 N.Y.S.2d 396 ; see 11 NYCRR 65–3.15 )."[A]n insurer must pay or deny only a verified claim—that is, a claim that has been verified to......
  • Presbyterian Hosp. in the City of New York v. General Acc. Ins. Co. of America
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    ...to preclude a defense that the coverage limits of the subject policy have been exhausted (see, Presbyterian Hosp. in City of N.Y. v. Liberty Mut. Ins. Co., 216 A.D.2d 448, 628 N.Y.S.2d 396). "Where, as here, an insurer has paid the full monetary limits set forth in the policy, its duties un......
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