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The Case of the Uninsured Cancer Patient: The Verdict

In June 2007, the Court of Appeals of Wisconsin agreed with the circuit court that Golden Rule’s contract with the Auls was unconscionable in terms of its substance. Patricia Aul’s breast cancer bore no medical connection to the benign cysts, which she had disclosed when she received the policy. Golden Rule should not have included a rider that had no medical basis.

But the court’s finding was not enough for the Auls to win the case. An unconscionable contract must be both unreasonable in substance, as Golden Rule’s rider was, and also be negotiated in a way that was unfair to the weaker party.

The court found that the Auls were well educated, experienced in shopping for insurance and capable of understanding the terms of the contract that were fully explained to them. The court rejected the idea that Golden Rule’s rider had put a black mark on Patricia’s record if she tried to get other insurance. The Auls had not tried to get other insurance, so they had not proved that they were backed into a corner by Golden Rule in terms of accepting the contract. Golden Rule was within its rights to deny Patricia’s breast cancer coverage.

Patricia Aul’s health story does have a happy ending. She had a lumpectomy, chemotherapy, radiation and took Tamoxifin for the next five years. Today, she is a cancer survivor, and “doing just fine,” according to her husband.

What do you think of the verdict? Let us know in the Community Commentary below.

 

Robin Gerber is a lawyer and the author of Barbie and Ruth: The Story of the World’s Most Famous Doll and the Woman Who Created Her.

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