South Carolina Jury Awards $10 Million In Health Insurance Rejection Case

Brad Hewett

Attorney

0 CommentsPrint ArticleSubscribe

The South Carolina Supreme Court upheld a multimillion verdict last month against an insurer which the Justices said revoked a man’s health policy after he tested positive for HIV based solely on a nurse writing down the wrong year for the test. The Court called Fortis Insurance Company’s actions “highly reprehensible” but reduced punitive damages awarded from $15 million to $10 million. The policyholder first found out he might have HIV when he tried to donate blood in April 2002. The Red Cross let him know his sample tested positive, and a trip to his personal physician confirmed the diagnosis.

Fortis said it revoked the policy because the policyholder didn’t reveal his diagnosis when he applied for insurance in May 2001 as the then 17 year old prepared to head to college and could no longer be covered under his mother’s policy. The company cited a note made by a nurse on a medical chart that incorrectly gave the wrong year for the test confirming the HIV diagnosis, placing it one day before the policyholder’s application for insurance.

The committee for the insurance company that decides whether to revoke policies heard the policyholder’s case along with 45 others in a two-hour session. The members were given a report from an underwriter that included the note” “Technically, we do not have the results of the HIV test. This is the only entry in the medical records regarding HIV status. Is it sufficient?” The policyholder hired a lawyer who sent the company the original test results with the correct date. But a second committee also upheld revoking the insurance and the policyholder didn’t have coverage for 20 months before Fortis reversed its decision, according to trial testimony. Fortis, which now does business as Assurant Health, appealed the case. The company’s “conduct involved repeated acts of deliberate indifference for more than two years,” the Justices wrote in their decision.

Source: Associated Press