Summary
In Presbyterian Hospital v. Liberty Mutual Insurance Co., 628 N.Y.S.2d 396, 397 (App. Div. 1995), the plaintiff claimed an insurance company's late denial of claim was untimely and therefore the defense of exhaustion was precluded.
Summary of this case from N. Jersey Brain & Spine Ctr. v. Hereford Ins. Co.Opinion
June 19, 1995
Appeal from the Supreme Court, Nassau County (Segal, J.).
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). 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; Schiff Assocs. v. Flack, 51 N.Y.2d 692; Employers Ins. v. County of Nassau, 141 A.D.2d 496).
We have considered the plaintiff's remaining contentions and find them to be without merit. Sullivan, J.P., Miller, Pizzuto and Friedmann, JJ., concur.