Callil v. California Physicians Service
The question presented in this case is whether a health care service plan complete[s] medical underwriting under Health and Safety Code section 1389.3 (section 1389.3) if, before issuing a plan contract, it does not attempt to check the accuracy of an application that itself does not raise any questions regarding the applicants medical condition.[1] In Hailey v. California Physicians Service (2007) 158 Cal.App.4th 452 (Hailey), the Fourth District, Division Three examined a health care service plans duty under section 1389.3, and concluded that the plan must make reasonable efforts to ensure the subscribers application was accurate and complete as part of the precontract underwriting process. (Id. at p. 459.) Court agree with the Hailey courts thoughtful and careful analysis. Accordingly, Court reverse the summary judgment in this case.
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