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MARY MARGARET HUFFMAN v. AETNA LIFE AND CASUALTY COMPANY (11/23/84)

filed: November 23, 1984.

MARY MARGARET HUFFMAN, APPELLANT,
v.
AETNA LIFE AND CASUALTY COMPANY, A CORPORATION



Appeal from the Order of the Court of Common Pleas, Civil Division, of Allegheny County, April Term, 1982, No. GD80-09872.

COUNSEL

Samuel J. Pasquarelli, Pittsburgh, for appellant.

Alan Shapiro, Pittsburgh, for appellee.

Rowley, Johnson and Popovich, JJ. Popovich, J., dissents.

Author: Rowley

[ 337 Pa. Super. Page 276]

This is an appeal from an Order which granted the appellee's motion for summary judgment. Appellant's husband, the late Arthur Huffman, was employed by the Western Pennsylvania Water Company, which provided its employees with a group hospitalization insurance policy issued by the appellee, the Aetna Life and Casualty Company. For various periods of time during 1977 and 1978, appellant's husband was confined at the Washington Hospital Extended Care Facility. The expenses incurred during the periods of confinement were slightly over $8,000. After appellant had made demand, appellee refused to pay for these expenses, claiming that the Washington Hospital Extended Care Facility was not a "hospital" within the meaning of the insured's policy. Appellant then instigated suit against the appellee, after which the appellee filed a petition to transfer the case to the arbitration docket. This petition was granted, and the arbitrators decided in favor of the appellant in the amount of slightly over $4,000. The appellee appealed the arbitrators' decision. A deposition was taken of Mary McHugh, the administrator of the Washington Hospital Extended Care Facility. The appellee then filed a motion for summary judgment. The trial court, agreeing with the appellee that the Washington Hospital Extended Care Facility could not be regarded as a "hospital," granted the summary judgment motion. Because we

[ 337 Pa. Super. Page 277]

    see the meaning of "hospital" under these circumstances as ambiguous and because the trial court did not sufficiently consider the expectations of Arthur Huffman as a policyholder, we reverse.

At the outset of this opinion, we emphasize the standards which are to be followed in determining whether a summary judgment motion should be granted. First, summary disposition of a case is permitted only in the "clearest of cases." Hankin v. Mintz, 276 Pa. Super. 538, 540, 419 A.2d 588, 589 (1980). Second, for a summary judgment to be upheld, there can be no genuine issues of fact and the moving party must be entitled to judgment as a matter of law. Rybas v. Wapner, 311 Pa. Super. 50, 457 A.2d 108 (1983). The case at bar was not among the "clearest of cases" ripe for summary judgment. Nor was the appellee entitled to judgment as a matter of law.

The task at hand is to determine whether the Washington Hospital Extended Care Facility can be regarded as a "hospital" as defined in the insurance policy. We begin this task by examining the policy to ascertain the intentions of the parties involved in the insurance agreement. Standard Venetian Blind Co. v. American Empire Insurance, 503 Pa. 300, 305, 469 A.2d 563, 566 (1983). In its policy, the appellee used seven elements to define "hospital."*fn1 Reproduced Record at 88a. Individual analysis of these elements sheds considerable light on the intentions of the parties.

[ 337 Pa. Super. Page 278]

The Washington Hospital Extended Care Facility meets the requirements of elements "b" through "e" in the policy's definition of "hospital." Ms. McHugh's testimony establishes that the Facility is, and was at the time of Mr. Huffman's confinement, open at all times and operated primarily for treatment of inpatients. Reproduced Record at 38a, 35a-36a, respectively. She also testified that physicians are and were available at all times and that a graduate registered nurse is and was present throughout each day. Reproduced Record at 42a-45a, 43a-44a, respectively.

Appellee contends that the Facility fails to meet the requirement of the next element, that to be a "hospital" an institution must provide "organized facilities for diagnosis and major surgery." Reproduced Record at 88a, 10(f). As authority for its position, appellee relies on Taylor v. Phoenix Mutual Life Insurance Company, 453 F.Supp. 372 (E.D.Pa. 1978), and Kravitz v. Equitable Life Assurance Society of U.S., 453 F.Supp. 381 (E.D.Pa. 1978), two other cases which applied Pennsylvania law to resolve the issue of whether an institution qualified as a "hospital" as ...


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