The Fourth Circuit decided a case that addresses an interesting insurance law question; while also touching on another issue that vexes medical malpractice lawyers in Maryland. The 4th Circuit overruled a great judge, Federal Magistrate Jillyn K. Schulze, who awarded summary judgment against a suspended surgeon for making a disability claim.
While cursed with a boring name, Certain Underwriters at Lloyd’s, London v. Cohen, is a case that has some interesting facts. The Plaintiffs are underwriters at Lloyd’s of London. The defendant was a general surgeon in Bethesda, who was suspended for three months from practicing medicine in Maryland, because he violated the standard of care, kept inadequate medical records and grossly over-utilized health care services. I’m not sure of all the details, but they are pretty strong allegations against a surgeon. Anyway, the insurers wanted to rescind a disability policy, because the doctor made material misrepresentations on a disability policy, which he later sought benefits.
What were the misrepresentations? There were three questions at issue. The doctor answered “Yes” to the question, “Are you actively at work?” six days before he signed the policy application. He represented that his “occupation” was “surgeon” and his “daily duties” were “surgery.” He responded “No” to the question, “Are you a party to any legal proceeding at this time?” and he also represented that he was not “aware of any facts that could change your occupation or financial stability.” In fact, he added, gratuitously as Federal Magistrate Jillyn K. Schulze would later point out, that he was “opening a D.C. Office.”