Mutual Hospital Insurance, Inc. v. Klapper

CASE SUMMARY — This is an appeal from a summary judgment entered in favor of plaintiffsappellees, Morris L. and Marietta Klapper (Klapper), based on their claim for Blue Cross benefits for a “pre-existing condition” excluded by a health insurance policy issued by defendant-appellant, Mutual Hospital Insurance, Inc. (Blue Cross). We reverse.

FACTS — The facts most favorable to Klapper (appellee) and in support of the judgment are:

On December 15, 1969, a family health insurance policy issued by Blue Cross to Klapper became effective. It contained the following provision:

“ARTICLE XII — BLUE CROSS…