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Presbyterian Hospital v. Empire Insurance Co

Appellate Division of the Supreme Court of New York, Second Department
Oct 30, 1995
220 A.D.2d 733 (N.Y. App. Div. 1995)

Opinion

October 30, 1995

Appeal from the Supreme Court, Nassau County (Levitt, J.).


Ordered that the judgment is modified, on the law, by deleting the provision thereof which awarded judgment to the plaintiff in the sum of $8,551.74 and substituting therefor a provision awarding judgment to the plaintiff in the sum of $2,206.79; as so modified, the judgment is affirmed insofar as appealed from, with costs to the defendants.

Prior to the hospitalization at issue on this appeal, the plaintiff's assignor had exhausted $47,793.21 of his $50,000 nofault policy. The plaintiff sued for reimbursement of a hospital bill in the amount of $8,551.74. The Supreme Court found that the defendants were precluded from raising the defense of exhaustion of the policy limits because the defendants failed to deny the claim. However, it was error to award judgment to the plaintiff for the full amount of the bill since "the failure to disclaim coverage does not create coverage which the policy was not written to provide" (Zappone v. Home Ins. Co., 55 N.Y.2d 131, 134; see, Schiff Assocs. v. Flack, 51 N.Y.2d 692, 700). The defendants cannot be held liable for benefits that exceed the amount contracted for in the policy. Rosenblatt, J.P., Pizzuto, Altman and Hart, JJ., concur.


Summaries of

Presbyterian Hospital v. Empire Insurance Co

Appellate Division of the Supreme Court of New York, Second Department
Oct 30, 1995
220 A.D.2d 733 (N.Y. App. Div. 1995)
Case details for

Presbyterian Hospital v. Empire Insurance Co

Case Details

Full title:PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK, as Assignee of SIMON…

Court:Appellate Division of the Supreme Court of New York, Second Department

Date published: Oct 30, 1995

Citations

220 A.D.2d 733 (N.Y. App. Div. 1995)
633 N.Y.S.2d 339

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