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LaPOLLO v. HOSPITAL SERVICE PLAN OF NEW JERSEY

113 N.J. 611 (1989)

552 A.2d 150

CHARLES J. LAPOLLO AND CHARLES P. LAPOLLO, PLAINTIFFS-RESPONDENTS, v. HOSPITAL SERVICE PLAN OF NEW JERSEY, A/K/A NEW JERSEY BLUE CROSS PLAN, A/K/A BLUE CROSS OF NEW JERSEY AND MEDICAL SURGICAL PLAN OF NEW JERSEY, A/K/A NEW JERSEY BLUE SHIELD PLAN, A/K/A BLUE SHIELD OF NEW JERSEY, JOINTLY, SEVERALLY, OR IN THE ALTERNATIVE, DEFENDANTS-APPELLANTS.

The Supreme Court of New Jersey.

Decided January 25, 1989.

Attorney(s) appearing for the Case

Dennis R. LaFiura argued the cause for appellants (Pitney, Hardin, Kipp & Szuch, attorneys; Dennis R. LaFiura, Donald W. Kiel, and Gary S. Margiotta, on the briefs).

Philip L. Faccenda argued the cause for respondents.

The opinion of the Court was delivered by O'HERN, J.

This appeal concerns the meaning of a standard clause in a New Jersey Blue Cross and Blue Shield hospital and surgical plan (Blue Cross/Blue Shield) that excludes from coverage certain claims covered by other medical reimbursement programs. Usually, the employer arranges such coverage and the subscriber has little to do with the terms of the contract.1...

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