SAN FRANCISCO (AP) â€” The state Supreme Court has unanimously upheld a man's claim for AIDS-related disability insurance despite his decision not to disclose testing positive for HIV in his policy application.
The court's decision Monday strongly encourages insurers to ask about medical conditions before a disability policy is issued or to ferret them out within two years.
But after two years, the court ruled, consumers can make disability claims based on illnesses that were not specifically excluded from the policy â€” even if those illnesses existed before the policy was purchased.
A lawyer for Mark Galanty, the man with AIDS, said the ruling has broad implications.
``People who become disabled â€” regardless of the cause â€” need no longer worry that an insurance company will dig through their medical files in an attempt to find a previous lab result, genetic test or medical condition to use as an excuse for refusing payment,'' said Jon Davidson of the Lambda Legal Defense and Education Fund, which handles civil rights case for gays, lesbians and people with AIDS or HIV.
Larry M. Golub, a lawyer for Paul Revere Life Insurance Co., which denied benefits to Galanty, said he had not read the ruling and declined comment. Lawyers for the American Council of Life Insurers, which supported the company in court, did not respond to requests for comment.
Galanty, 52, of Studio City, was working as a free-lance court transcriber when he tested positive for HIV in 1987. He was told the result was unreliable unless confirmed by a second test, but chose not to get a follow-up test.
In March 1989, Galanty bought his Paul Revere disability policy. The company didn't ask whether he had AIDS or whether he had tested positive for HIV. The policy did not exclude people with either of those conditions.
In September 1994, Galanty claimed disability based on AIDS and on an AIDS-related condition that causes numbness and pain in the hands and feet.
Paul Revere initially paid benefits, but denied coverage for about two years once it discovered the positive HIV test â€” which the company said amounted to a pre-existing condition.
About two years after Paul Revere cut off Galanty's AIDS-related benefits, he began collecting for a different, non-AIDS disability: tremors in his hands. Monday's ruling, which overturns two lower court rulings, means he will get about $72,000 in compensation.