Brandt v. Time Insurance

704 N.E.2d 843, 302 Ill. App. 3d 159, 235 Ill. Dec. 270
CourtAppellate Court of Illinois
DecidedDecember 10, 1998
Docket1—97—2913, 1—98—0143 cons.
StatusPublished
Cited by28 cases

This text of 704 N.E.2d 843 (Brandt v. Time Insurance) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brandt v. Time Insurance, 704 N.E.2d 843, 302 Ill. App. 3d 159, 235 Ill. Dec. 270 (Ill. Ct. App. 1998).

Opinions

JUSTICE HOFFMAN

delivered the opinion of the court:

The plaintiff, Jacqueline Brandt, filed the instant action against the defendant, Time Insurance Company (Time), and others to recover damages she allegedly sustained as a consequence of Time’s refusal to pay her claims under a health insurance policy. Brandt’s complaint as amended set forth, inter alia, claims against Time for breach of contract (count I), a violation of section 155 of the Illinois Insurance Code (215 ILCS 5/155 (West 1996)) (count II), fraud (count IX), and a violation of the Illinois Consumer Fraud and Deceptive Business Practices Act (Consumer Fraud Act) (815 ILCS 505/1 et seq. (West 1996)) (count X). On July 17, 1997, the circuit court dismissed counts IX and X of Brandt’s complaint for failure to state causes of action, including within its order the requisite finding of appealability under Supreme Court Rule 304(a) (134 Ill. 2d R. 304(a)). Brandt filed a timely notice of appeal from that order which was docketed in this court as appeal No. 1 — 97—2913. Thereafter, on January 8, 1998, the circuit court granted summary judgment in favor of Time on counts I and II of Brandt’s complaint, again including within its order the requisite finding of appealability under Supreme Court Rule 304(a). Brandt filed a timely notice of appeal from the January 8 order which was docketed in this court as appeal No. 1 — 98—0143.

Brandt died after the filing of her appeals and Howard E. Turna, special administrator of Brandt’s estate, was substituted as the appellant. In the interest of clarity, however, we shall continue to refer to Brandt as the plaintiff. We consolidated Brandt’s appeals and, for the reasons that follow, we now (1) affirm the July 17, 1997, order of the circuit court dismissing counts IX and X, (2) reverse the summary judgment entered on January 8, 1998, in favor of Time on counts I and II, and (3) remand this cause to the circuit court for further proceedings consistent with this opinion.

Brandt was diagnosed as a Type II diabetic in 1988. Beginning in 1990, Douglas Ruth, an insurance broker, assisted Brandt in obtaining health insurance policies. In 1994, Brandt was issued two short-term medical (STM) insurance policies, which provided coverage for a maximum of six months and were intended to provide interim coverage while she sought a comprehensive medical insurance policy. Brandt’s STM policies excluded her diabetes from coverage as a preexisting condition.

In March 1995, Ruth Informed Brandt that her current STM policy was about to expire and recommended that she apply for an STM policy offered by Time. Ruth completed the Time application for Brandt and answered the questions contained therein, including the following:

“4. Within the last five (5) years, have you, your spouse, or any dependent to be covered, ever received any medical or surgical diagnosis or treatment including medication for: heart or circulatory system disorder including heart attack or chest pain; stroke; diabetes; cancer ***.
Note: The policy *** cannot be issued if YES is answered on any questions, 2-4.”

Ruth answered “No” to question 4, although he knew of Brandt’s diabetic condition. Ruth sent Brandt’s application with her premium check to Insurance Consulting Group (ICG), a company that processes insurance applications for policies issued by Time. Time issued the policy to Brandt, effective April 4, 1995.

On or around August 1, 1995, while her Time STM policy was in effect, Brandt was diagnosed with terminal stomach cancer. Brandt incurred medical bills for treatment of the cancer which she submitted to Time for payment. Before paying out on Brandt’s claims, Time discovered that Brandt had suffered from diabetes since 1988 and had been treated for her condition within the five-year period prior to her application for its STM policy. Time denied Brandt’s claim for benefits and notified her on October 30, 1995, that it was rescinding the STM policy.

Brandt filed the instant action against Time, Ruth, and Ruth’s company, Lenox Financial Services, Inc., on April 4, 1996. Brandt’s complaint alleged, inter alia, that Ruth obtained her signature on a blank application for Time’s STM policy, represented to her that he would fill it out accurately, and then recklessly filled out the application without indicating that Brandt suffered from diabetes. According to her complaint, Brandt had never seen the completed application until Time refused to honor the policy. Brandt alleged that Time was precluded from relying on Brandt’s diabetes as a basis for denying coverage since it failed to attach the application to the policy (see 215 ILCS 5/154 (West 1994)). Brandt claimed that, by refusing to honor the policy, Time breached its contract of insurance (count I) and violated section 155 of the Insurance Code (215 ILCS 5/155 (West 1996)).

Time filed its answer along with affirmative defenses alleging that the STM policy was void ab initio since the misrepresentations in Brandt’s application were material to Time’s decision to accept the risk, were material to the hazard assumed by Time, and were made with the intent to deceive.

On December 2, 1996, Brandt amended her complaint, adding two new counts alleging that Time’s practice of “post-claim underwriting” constituted common law fraud (count IX) and an unfair and deceptive trade practice under the Consumer Fraud Act (815 ILCS 505/1 et seq. (West 1996)) (count X). Time moved to dismiss counts IX and X for failure to state causes of action. The trial court granted the motion and Brandt was given leave to replead within 28 days. No amended complaint was filed, and counts IX and X were dismissed with prejudice.

I. APPEAL FROM THE DISMISSAL OF COUNTS IX AND X

On appeal from a motion to dismiss under section 2 — 615 of the Code of Civil Procedure (735 ILCS 5/2—615 (West 1996)), this court must determine whether the complaint alleges facts which, if proved, would entitle the plaintiff to relief. Charles v. Seigfried, 165 Ill. 2d 482, 485-86, 651 N.E.2d 154 (1995). Our review is de novo. Kaden v. Puchinski, 287 Ill. App. 3d 546, 548, 678 N.E.2d 792 (1997).

In order to plead an action for fraud, the plaintiff must allege: that the defendant made a false statement of material fact, knowing or believing that the statement was false, with the intention of inducing the plaintiff to act; that the plaintiff reasonably relied on the truth of the statement and acted thereon; and that the plaintiff suffered damages that were proximately caused by her action in reliance upon the statement. Siegel v. Levy Organization Development Co., 153 Ill. 2d 534, 542-43, 607 N.E.2d 194 (1992). The basic elements of a deception claim under section 2 of the Consumer Fraud Act (815 ILCS 505/2

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Cite This Page — Counsel Stack

Bluebook (online)
704 N.E.2d 843, 302 Ill. App. 3d 159, 235 Ill. Dec. 270, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brandt-v-time-insurance-illappct-1998.