5. With the exception of surgery for obesity, does your practice include weight reduction or control by other than [sic] diet or exercise?
5.(b) Do you dispense any drugs?
5.(c) Do you use injections for weight control?
9.(a) Do you use experimental procedures, devices, drugs, or therapy in treatment or surgery?
In June 2011, a former patient of the Galilee physician brought an action for negligence based on treatments she received for injections into subcutaneous layers of fat that was intended to dissolve the fat. The patient claimed that developed painful, infected, blister-like granulomas after the injection. The physician admitted to providing such therapy to over 5,000 patients. Galilee sought coverage for the claim under the Essex Policy and Essex denied coverage and filed a declaratory judgment action, seeking rescission of the policy based on the answers given by Galilee and its physician in the insurance application, which Essex claimed were materially false. Essex filed a motion for summary judgment on March 22, 2013 and the District Court granted the motion. Galilee appealed. The Seventh Circuit noted that under Illinois law, insurers may deny coverage and rescind a policy if a statement in the insurance application is false and the false statement was either made with intent to deceive the insurer or if it materially affects the insureraEUR(TM)s acceptance of the risk. The Seventh Circuit found that due to GalileeaEUR(TM)s failure to disclose on its application information related to administering and recommending weight reduction procedures with experimental drugs, Essex was not able to correctly price the policy it issued to Galilee based on the risk it was actually undertaking. Accordingly, the Seventh Circuit affirmed the District CourtaEUR(TM)s order because it found that GalileeaEUR(TM)s misrepresentations were material and warranted rescission of the policy.Review articles and blog posts by our list of insurance experts!
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