Federal appeals court resolves insurance policy ambiguity in favor of cancer patients

The term “actual charges” in supplemental cancer insurance policy was ambiguous and must be construed in favor of a South Carolina cancer patient, the United States Court of Appeals for the Fourth Circuit ruled Nov. 29, 2008. The ruling, reported on by Gregory Froom in the March 2, 2009 edition of South Carolina Lawyers Weekly, resulted from a rehearing after an earlier appellate panel issued an opinion in October.

The decision ends a dispute over what the undefined term “actual charges” meant in a cancer policy that the plaintiff contends entitles her to recover what the doctors billed, not just the discounted rate the insurer claims it paid.

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