Faruque v. Provident Life & Accident Insurance

The first issue presented for our determination is whether the express terms of the excess major medical insurance policy permit a modification of the allowable benefits payable; or whether plaintiffs’ rights to unlimited nursing care benefits vested, thus entitling them to such benefits under the original terms of the excess policy.

Defendants-appellees argue that the operative provision relied on by the court of appeals below (i.e., the “Benefit Provision”) guarantees benefits solely for expenses incurred within a benefit period. It is the defendants’ contention that the policy in issue is a…