Procedural Posture
Appellant health insurance applicant sought review of a summary judgment from the Superior Court of Los Angeles County (California), which ruled that respondent insurer was entitled to rescission of a health insurance policy as a matter of law because the applicant had made material misrepresentations and omissions regarding her medical history.
Overview
The applicant failed to disclose her chronic back problems, the medications she took for them, and multiple visits to two doctors. She was advised that misrepresentations could result in termination of the policy. A subsequent investigation resulted in discovery of the misrepresentations. The court noted that although the trial court had previously denied summary judgment, Code Civ. Proc., §§ 437c, subd. (f)(2), did not bar the insurer's renewed motion because it raised the additional issue of fraud and because the prior motion was not one for summary adjudication. Moreover, EEOC attorney Code Civ. Proc., § 1008, did not prohibit reconsideration sua sponte. Regardless of the applicant's intent, the insurer was entitled to rescission based on concealment under Ins. Code, §§ 330, 331, 332, 359, of facts that were material as defined in Ins. Code, § 334, based on two underwriters' declarations that the insurer would not have issued the policy had the facts been disclosed. The application requirements of Ins. Code, §§ 10113, 10381.5, did not preclude rescission based on fraud. Postclaims underwriting in violation of Ins. Code, § 10384, did not occur. The applicant's bad faith claim was meritless.
Outcome
The court affirmed the judgment of the trial court.
The court affirmed the judgment of the trial court.