Ledingham v. Blue Cross Plan for Hospital Care of Hospital Service Corp.

• Decision Date: 01 October 1976
• Docket Number: No. 48114,48114
• Parties: , 1 Ill.Dec. 75 Harold A. LEDINGHAM et al., Appellants, v. BLUE CROSS PLAN FOR HOSPITAL CARE OF HOSPITAL SERVICE CORPORATION et al., Appellees.
• Court: Illinois Supreme Court

Page 75

356 N.E.2d 75

64 Ill.2d 338, 1 Ill.Dec. 75

Harold A. LEDINGHAM et al., Appellants, v. BLUE CROSS PLAN FOR HOSPITAL CARE OF HOSPITAL SERVICE CORPORATION et al., Appellees.

No. 48114.

Supreme Court of Illinois.

Oct. 1, 1976.

Stobbs Law Office, Ltd., Alton (John Dale Stobbs, Alton, of counsel), for appellants.

Meyer & Kaucher, Belleville (Robert F. Kaucher, Belleville, of counsel), for appellees.

UNDERWOOD, Justice:

A Madison County circuit court jury awarded plaintiffs, Harold A. Ledingham and his wife Rita, $9,200 as compensatory and punitive damages for the failure of corporate defendants Blue Cross Plan for Hospital Care of Hospital Service Corporation and Blue Shield of Illinois Medical Service to honor plaintiffs' claims for amounts paid by them for medical and hospital care. Defendants appealed from the judgment entered on that verdict, and the Fifth District Appellate Court reversed the punitive damages award, directing the trial court to enter judgment for $1,592.85, the amount of the compensatory damages and interest. (29 Ill.App.3d 339, 330 N.E.2d 540.) The original appellate court opinion filed June 12, 1975, made no reference to the costs of the litigation. Its mandate, issued July 21, treated its judgment as a reversal, and authorized defendants to recover their costs from plaintiffs. Thereafter defendants requested the appellate court clerk to tax various items as costs in a total amount of $2,557.30. Immediately upon receiving a copy of that request on October 29, plaintiffs moved that the appellate court reconsider the matter of costs, and that court then disallowed several items, apportioning the remainder 70% Against plaintiffs and 30% Against defendants. So divided, defendants' costs assessed against plaintiffs total $1,522.92. Plaintiffs sought and we allowed leave to appeal.

Sometime after July 15, 1969, plaintiffs applied to defendants for medical had hospitalization coverage and were issued a policy with an effective date of August 1, 1969. No physical examination was required of the insureds, but the policy contained an exclusion for preexisting illnesses or conditions. Since 1967 Mrs. Ledingham had consulted a doctor every six months for routine gynecological examinations and 'Pap Tests.' Her most recent test before applying for medical coverage was in mid-May, 1969, and the results were negative.

On August 3, 1969, Mrs. Ledingham experienced prolonged and excessive vaginal bleeding. Bed rest and medication failed to cure her condition, and on August 14 a diagnostic dilatation and curettage was performed with inconclusive results. Her condition stabilized until about September 9, when she hemorrhaged and was given medication. Her condition again stabilized briefly, but then degenerated, and on October 6, her doctor diagnosed the presence of an adenoma, a precursor of a uterine tumor. Finally, on November 25, 1975, a hysterectomy was performed. After the surgery, a pathologist confirmed the presence of the adenoma, and also discovered two small tumors within the wall of the uterus, called leiomyomata.

Plaintiffs submitted claims for medical and hospital expenses totaling $1,549.60, but defendants refused payment on the grounds that the conditions from which Mrs. Ledingham suffered had existed prior to the effective date of the policy and were excluded from coverage. Defendants based their refusal to pay on their belief that Mrs. Ledingham's condition could not have arison and progressed to its severity in the two-day period from August 1 to August 3, when she began hemorrhaging. Defendants also relied on a December 5, 1969, report which they received from Mrs. Ledingham's doctor. In it the doctor stated that it was 'unknown' whether the adenoma and leiomyomata were present on August 1, 1969; that symptoms first appeared after August 1; and that no medical or surgical treatment had been provided for these conditions before August 1. When sued, defendants asserted the affirmative defense of a preexisting condition but presented no evidence at trial.

As earlier indicated, the appellate court reversed the punitive damages award on June 12, 1975. No petition for rehearing was filed, nor was leave to appeal from that judgment sought by either party. While plaintiff now argue that the appellate court reversal of the punitive damage award was erroneous, consideration of that question is precluded by their failure to seek review within the prescribed time limits. Ill.Rev.Stat.1975, ch. 110A, par. 315(b).

Defendants argue that the appellate court order apportioning costs is not properly before us. They urge that plaintiffs' October 29 motion was filed too late if intended as a petition for rehearing, since the time for seeking rehearing...