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Universe Life Insurance Co. v. Giles

950 S.W.2d 48 (1997)

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Universe Life Insurance Co. v. Giles

Texas Supreme Court
950 S.W.2d 48 (1997)

SC

Facts

Ida Mae Giles (plaintiff) bought a health-insurance policy from the Universe Life Insurance Company (Universe) (defendant). Giles had heart surgery about three months later, and Universe declined to cover the surgery. Universe claimed that Giles’s heart condition existed prior to her buying the health insurance. This claim was based on a typographical error in and misunderstanding of Giles’s medical record. The error and misunderstanding were later clarified to Universe, indicating that Giles’s heart issues were not preexisting conditions. Despite the clarification, Universe continued to decline coverage. Approximately six months later, Universe received a letter from Giles’s attorney. Once the attorney got involved, Universe agreed to pay the substantial majority of Giles’s medical bills. Giles sued Universe for breach of the duty of good faith and fair dealing. The trial court ruled in Giles’s favor and awarded her $75,000 for mental anguish and $500,000 for punitive damages. The court of appeals reduced the award for punitive damages to $300,000 but otherwise affirmed the decision. Universe appealed.

Rule of Law

Issue

Holding and Reasoning (Spector, J.)

Concurrence (Hecht, J.)

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