NYH-CUMC-NEURO/SURG v. ERNA RAPPA

 

NOT FOR PUBLICATION WITHOUT THE

APPROVAL OF THE APPELLATE DIVISION

SUPERIOR COURT OF NEW JERSEY

APPELLATE DIVISION

DOCKET NO. A-3332-04T13332-04T1

NYH-CUMC-NEURO/SURG,

Plaintiff-Respondent,

v.

ERNA RAPPA,

Defendant-Appellant.

__________________________________________

 

Submitted: June 5, 2006 - Decided June 27, 2006

Before Judges A. A. Rodr guez and Fall.

On appeal from the Superior Court of New Jersey, Law Division, Civil Part, Ocean County, L-1349-04.

Rothstein, Mandell, Strohm & Must, attorneys for appellant (Valter H. Must, on the brief).

Craner, Satkin, Scheer, Schwartz & Arnold, attorneys for respondent (Maged W. Hanna, on the brief).

PER CURIAM

Defendant, Erna Rappa, appeals from an order granting summary judgment in favor of plaintiff, Nyh-Cumc-Neuro/Surg, in the amount of $17,947.50. We affirm.

Plaintiff sued Rappa, alleging an unpaid balance for medical services rendered by Howard Antony Riina, M.D. on December 4, 2001. Rappa answered, denying all allegations. She also sent a notice to take the deposition of Dr. Riina.

Plaintiff moved for summary judgment. Rappa opposed the motion and cross-moved for discovery because plaintiff had failed to produce Dr. Riina for depositions. The motions were carried in order to conduct discovery. Plaintiff filed a certification by Dr. Riina, who indicated that he is a Board Certified Neurosurgeon. He operated on Rappa on December 4, 2001 at the New York Weill Cornell Medical Center. He certified that the procedures performed were medically necessary for the treatment of Rappa's thyroid cancer and that the fees charged were reasonable and customary for a Board Certified Neurosurgeon in New York City.

In opposition, Rappa certified that she sought the services of Mark Tuttel, M.D. of Sloan Kettering Cancer Center after being assured by her insurer, Horizon Blue Cross Blue Shield of New Jersey, that his services would be covered. According to Rappa:

Dr. Tuttel recommended that [I] undergo surgery and directed me to a Dr. Bilker also at Sloan Kettering. At no time did anybody suggest or advise that this treatment would not be covered by my insurance as I was lead to understand that all of my treatments through Sloan Kettering would be covered by my insurance.

I then met with Dr. Bilker who sent me to Dr. Riina who happens to be at the New York Weill Cornell Medical Center which is directly across the street from Sloan Kettering. At no[] time did anybody ever suggest that I should check or make sure that his treatment was covered by my insurance. Since I was being directed by Dr. Bilker, I assumed that they were all working together. Had I known that the services for Dr. Riina would not be covered by my insurance, I would have made alternate arrangements.

. . . .

When I went to see Dr. Riina they asked to see my insurance card. They made a copy of it and then gave it back to me. At no[] time did anybody ever tell me that the treatment that I was about to receive was not covered by my insurance.

Furthermore, the surgery that I received from Dr. Riina was only a minor step to the surgery that was to be performed by Dr. Bilker. . . . The surgery by Dr. Riina was performed out-patient. I went in at 10:30 a.m. and was transferred across the street to Sloan Kettering at approximately 7:30 that evening. Then the main surgery [by Dr. Bilker] occurred the following morning. As far as I knew this was all part of the same process and was all covered by my insurance.

The judge denied Rappa's application and signed the order under review. On appeal, Rappa contends that "there was no express agreement between the parties" and she was referred to Dr. Riina by physicians at Sloan Kettering "with whom she had an express agreement that all of the services rendered to her would be covered by her healthcare insurance." We understand Rappa's predicament, however, it does not alter her obligations with respect to plaintiff's right to be compensated for services rendered.

Contract law principles govern payment for medical services rendered to patients. D'Ascoli v. Stieh, 326 N.J. Super. 499, 504 (App. Div. 1999). Pursuant to contract principles, a patient is required by implication, to pay for medical services rendered, unless it is either expressly stated or the circumstances create a reasonable impression, that the services are gratuitous. Shapiro v. Solomon, 42 N.J. Super. 377, 383 (App. Div. 1956).

Here, in viewing the facts in the light most favorable to Rappa, Brill v. Guardian Life In. Co., 142 N.J. 520, 524 (1994), we note that Rappa makes no allegation that she was led to believe that Dr. Riina's services were free. Rather, she assumed that her insurance coverage would extend to Dr. Riina's treatment. This unilateral assumption is not a failure of the parties' mind to meet. Ibid. The parties agreed that Dr. Riina would perform the operation and he would be paid. We note that Rappa did not make it a condition of her contract with Dr. Riina that he would perform the surgery only if his services were fully covered by her insurer.

 
Affirmed.

According to respondent's brief, defendant has since died. Collection efforts are being pursued against her estate.

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A-3332-04T1

June 27, 2006