January 26, 2010

St. Vincent’s Hosp. & Med. Ctr. v Allstate Ins. Co. (2010 NY Slip Op 00668)

Headnote

The main issues decided in this case involved an action to recover no-fault medical benefits under an insurance contract. The defendant, Allstate Insurance Company, appealed from an order and judgment granting the plaintiff's motion for summary judgment on the complaint, and in favor of the plaintiff in the principal sum of $32,086.70. The court considered whether the accident in which the plaintiff's assignor was injured was an insured incident, and whether the defense of lack of coverage is precluded by the defendant's failure to pay or deny the subject no-fault claim within the requisite 30-day period. The holding of the court was that the Supreme Court should have denied the plaintiff's motion for summary judgment on the complaint and granted the defendant's cross motion for summary judgment, dismissing the complaint.

Reported in New York Official Reports at St. Vincent’s Hosp. & Med. Ctr. v Allstate Ins. Co. (2010 NY Slip Op 00668)

St. Vincent’s Hosp. & Med. Ctr. v Allstate Ins. Co. (2010 NY Slip Op 00668)
St. Vincent’s Hosp. & Med. Ctr. v Allstate Ins. Co.
2010 NY Slip Op 00668 [69 AD3d 923]
January 26, 2010
Appellate Division, Second Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, March 10, 2010
St. Vincent’s Hospital & Medical Center, as Assignee of Jane Fritz, Respondent,
v
Allstate Insurance Company, Appellant.

[*1] McDonnell & Adels, PLLC, Garden City, N.Y. (Martha S. Henley of counsel), for appellant.

Joseph Henig, P.C., Bellmore, N.Y., for respondent.

In an action to recover no-fault medical benefits under an insurance contract, the defendant appeals from an order and judgment (one paper) of the Supreme Court, Nassau County (Feinman, J.), entered January 14, 2009, which, upon a decision of the same court dated December 3, 2008, granted the plaintiff’s motion for summary judgment on the complaint, in effect, denied the defendant’s cross motion for summary judgment dismissing the complaint, and is in favor of the plaintiff and against it in the principal sum of $32,086.70.

Ordered that the order and judgment is reversed, on the law, with costs, the motion is denied, the cross motion is granted, and the complaint is dismissed.

In support of its cross motion, the defendant made a prima facie showing of entitlement to judgment as a matter of law by demonstrating that the accident in which the plaintiff’s assignor was injured was not an insured incident (see Central Gen. Hosp. v Chubb Group of Ins. Cos., 90 NY2d 195, 199 [1997]; see generally Alvarez v Prospect Hosp., 68 NY2d 320 [1986]). In opposition to the defendant’s prima facie showing, the plaintiff failed to raise a triable issue of fact. Contrary to the plaintiff’s contention, the defense of lack of coverage is not precluded by the defendant’s failure to pay or deny the subject no-fault claim within the requisite 30-day period (see Hospital for Joint Diseases v Travelers Prop. Cas. Ins. Co., 9 NY3d 312, 318 [2007]; Central Gen. Hosp. v Chubb Group of Ins. Co., 90 NY2d at 199).

Accordingly, the Supreme Court should have denied the plaintiff’s motion for summary judgment on the complaint, and granted the defendant’s cross motion for summary judgment dismissing the complaint.

The plaintiff’s remaining contentions are without merit. Rivera, J.P., Dillon, Miller and Roman, JJ., concur.