Cardamone v. Allstate Insurance

Plaintiffs brought this action to recover medical benefits under a health insurance policy. The trial court granted defendant’s motion for summary judgment. On appeal plaintiffs contend: (1) that an exclusionary provision in the policy does not apply and, alternatively, if it does apply, (2) that defendant’s agent waived this provision.

On February 25, 1974, plaintiffs entered into a contract of health insurance, under which defendant agreed to pay certain medical expenses incurred as a result of sickness or injury. The policy defined sickness as follows:

“Sickness means sickness or disease…