On Friday a case was removed from Oklahoma state court Western District of Oklahoma. The case was filed by an insured against National Health Insurance Company. His lawsuit alleges improper non-payment of medical bills, as well as complete rescission of the medical policy at issue.
The plaintiff, according to the original state court complaint, purchased a short term medical policy effective September 1, 2020. As a part of issuing the policy, the defendants required detailed information about the plaintiff’s medical history.
After the policy was issued, the plaintiff was diagnosed with cancer and sought medical treatment. As a part of this medical treatment process, the plaintiff said they properly sought and received authorization for the procedure and submitted the claim for processing. However, the complaint said that the claim was not immediately processed and the defendant notified the plaintiff that they were conducting an investigation as to the policy, seeking any reason why the policy could be rescinded instead of processing the bill.
The defendant allegedly discovered that the plaintiff had received back surgery in a previous year, unrelated to the cancer diagnosis. However, because that condition was not disclosed during the medical history process, the defendant rescinded the entire policy.
The plaintiff is suing for breach of contract due to ambiguity regarding the terms of the contract regarding the medical history process, as well as breach of good faith and duty regarding recission of the policy. The insured is represented by Fulmer Sill PLLC. The defendant is represented by Pierce Couch Hendrickson Baysinger & Green.