Hospital for Joint Diseases v. Allstate Ins. Co

In Hospital for Joint Diseases v. Allstate Ins. Co. (21 AD3d 348, 800 NYS2d 190 [2d Dept 2005]), the Appellate Division, Second Department, further spelled out how this defense could be raised, albeit through a motion for summary judgment. After a plaintiff made out a prima facie case, the defendant had to raise a triable issue of fact as to whether the medical expenses submitted beyond a year after the accident "were for injuries for which expenses for treatment had not been submitted to it within one year of [his] accident." (Id. at 349, quoting Stanavich at 873; see 11 NYCRR former 65.15 [now 65-1.1].) The court also held that the defendant's failure to assert this statutory-exclusion defense within 30 days of the receipt of the no-fault claim constituted a waiver. (Id.)