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Stafkings Health Care Systems, Inc. v. Blue Cross and Blue Shield of Utica-Watertown, Inc.
Citations: 221 A.D.2d 908; 635 N.Y.S.2d 387; 1995 N.Y. App. Div. LEXIS 13386Docket: Appeal No. 1
Court: Appellate Division of the Supreme Court of the State of New York; November 14, 1995; New York; State Appellate Court
The court modified the order and affirmed it without costs, noting that the Supreme Court erred by not dismissing the plaintiff's second cause of action for negligent misrepresentation. The plaintiff, a health care provider, claimed that they contacted the defendant insurer to verify coverage for certain services under a group policy with an employer. An employee of the insurer confirmed coverage, leading the plaintiff to provide those services. Subsequently, the insurer denied coverage based on a policy exclusion. The plaintiff contended that they relied on the insurer's negligent misrepresentation when providing the services. For a tort recovery due to pecuniary loss from negligent misrepresentation, there must be either actual privity of contract or a relationship closely resembling privity between the parties. The court found that the plaintiff did not establish such a relationship, as a single unsolicited phone inquiry was insufficient to create a special relationship. The ruling referenced several precedents, emphasizing that the plaintiff's actions did not meet the necessary legal threshold.