THIRD DIVISION DECEMBER 26, 2007 1-06-1203 DONALD C ONTI, Indiv idua ll y a nd as Speci

al ) Appe al fro m the Ad m i nistrator f or the Es tate of P atri cia Con ti, D ece ase d, ) Ci rcu i t Cou rt of ) Co o k C o un t y. Plai ntif fs-Appel lan ts, ) ) v. ) No. 04 CH 20851 ) HEALTH CA

RE SERVICE CORPORATION, a Mutual ) Le gal Re serv e C om

pa ny , d/ b/ a B l ueCros s B l

ueSh i el d of ) Ill in ois, ) Ho no r ab le ) Doro thy K

in nai rd, Defe ndan t-Appell ee. ) Judge Presidin g. JU STI CECU

NN IN GH AM del i v ered th e op i n i on of th e c our t: The pla int iffs, Do na ld a nd Pa t r icia Co nt i, filed a la ws uit in t he cir cu it cou rt of Cook Cou n ty agains t th e def en da n t, Heal th Care Service Corporat ion, a m utualle gal

reserve com

pany , d/b/a/ Bl ue Cross Blu e S hie ld

o f I llino is. P lain t iffs so ug ht a d ec lar at o ry j ud gm en t to re i n sta te th ei r hea l th in surance pol i cy an d da mag esf or brea ch of con tract res ul ti ng f rom the ca nc el l ati on of the origi

nal po licy. Aft er t his la ws uit wa s file d, Pa t r icia Co nt i die d, an d D o na ld C o nt i n ow appe ars in his in div idua l ca paci ty an d a s s pe ci al ad m i ni stra torfor the estate of Patrici a Conti. The pl ai ntif fs appeal fro m an or der of t he cir cu it co ur t gr ant ing t he de fendant ’s mot ion fo r su mmary judgment pur sua nt to section 2-100 5 of

the C ode of

Ci vi l Procedu re (735 IL CS 5/2 -1005 (We st 2004 )). Th e p laint iffs
ar gue t hat t he trial

court erred by : (1) fi

ndi ng that their i

nsuran ce appl i cation represe

ntati ons were false as a ma t t er o f law ; a nd ( 2) find ing t ha t t he misr ep r es en t at io ns w er e ma t er ial. We affirm t he ord er of th e c i rc ui t cou rt.1-06-1203

2 BACK GROUND The followi

ng f acts have been add ucedf rom th e rec ord . In

20 04 , the p l ai

n ti f f s dec i de d to purchase h ea

l th in surance f rom the def

endan t. On Marc

h 25 , 2004, P atri cia vi si

ted h er i ntern i st, Dr. Cybo r sk i, for a phy

si cal exam in ation be cause sh

e was experienci

ng an upsetsto mach . Acc ordi

n g to Dr. Cybor ski’s no t es, Pat ricia co mplained t hat she ha d no app et ite a nd had be en expe riencing abdom in al pai n f or the pa st two to three da y s. Dr. Cy

b ors ki n oted th at th e p ati en t h ad n o h ea l th in surance and m igh t need an ult ra so und a nd CAT scan of the abdom

en. However, Dr. Cyborski put the tests on “

hol d.” Dr . C ybor ski pr esc ribed Pr ot onix and not ed t hat t he pa t ien t wa s t o ca ll him if the sy m ptoms worsen ed. On Ma rc h 29 , 20 04 , the p l ai

n ti f f s s ub m i tted an appl i ca ti on to th e def

en da n t f or hea l th insurance. The plai

ntif fs answered “No” t o all of the foll owing questions: “3. Has any

person appl

yi ng f or co ver ag e been

advi sed, counseled, tested, diagnosed, treated, hos pi tal ize d, or recomm ended for treatment wi

thi n the l ast 10 y ears f or the fol l owin g: *** (F) Hern i a; col i ti s; chr onic diarrhea or in test in al problem

s; hem orrhoids orrectal di sorder; gastroeso phageal refl ux; a ny dis order of t he es op hagu s; ulce r o f the st omac h or duo denu m , or any ot her diges t ive or der or co ndit ion?
*** 4. Du ri ng the l as t 5 y ea rs , h asan

y pe rs on a

ppl y i ng f or1-06-1203

3 coverage ha d a

ph ysic al e xa minat io n ( inc lud ing ch ec k- up s) , dia gn o st ic tests, con su l ted a p h y si ci an , c h i rop ra ctor or th erap i st? 5. Has any

person appl

yi ng f or co verage b een

pr esc ribed any medi ca ti on due to sickn

ess, disease, dis o rde r, c ond i ti on, i njury , or co unse ling

or for smoki

ng c e ssation or wei

ght loss i n the l ast 12 mont hs?
*** 9. H as any

person appl

yi ng f or co verage di scussed or been advi sed to have treatm

en t, testi ng, c ouns el

i ng, t h erapy , or surge ry which has not yet be en pe rfo rmed ?” The s i gned

appl i cati on al so contai

ned the f oll owin g clause i n b old ty pe: “I have re ad a ll the st at ement s in PART ONE AND T WO, and
re pr ese nt that t hey

are true an d c o mple t e t o t he be st o f my knowle dge and belief. I u nder st and t hat t he fai lure to d iscl

ose the i nf orm ati on on PAR TS ONE AND TWO of

this applic ation m

ay be the basis f or f uture cl ai m de ni al , re ci ss i on or

ref orm ati on as o f the or iginal effect ive date, solel y a t t he di scretion of the c ompan y.” The pla int iffs d id n o t men t io n P at r ic ia ’s Mar ch 25 v is it to t he doctor in the i nsuran ce app licatio n. Ad di t io na lly, in d ep o sit io n t es t imo ny, Patrici a stated t hat she s ought foll ow-up t re at ment f rom Dr . C ybor ski wit hin tw o w eek s o f her initial visit be cau se he r sympt oms “c hange d. ” At t he Ap r il 1 vi si t, Dr. Cybor ski diag nos ed P at ricia wit h “po ssible diver t iculitis” a nd re co mmended t hat she1-06-1203

4

see Dr . S op er for a se co nd o pinion. Pa t r icia wa s e xa mined by D r . So pe ro n Ap r il 1, 20 04 . Dr . So pe rno t ed in his re co rd s t hat he bel ie ved t ha t Pa t r icia ha d a cu t e d ive r t icu lit is. Dr . So pe rno t ed t ha t Pa t r icia had n o ins urance, di d n ot wish to be h ospitaliz ed or undergo a CAT scan an d desi red t o “t ry t o t r ea t t his a s c o nse rva t ive ly as possi bl e.” Dr . S op er pr esc ribed Flagyl and Le vaqu in for t he diver t iculitis and inst ruc t ed Pa t r icia to co nt ac t him

if the sy mptoms did n ot im prove in the nex t 48 hours. Dr. Cy

borski not ed Dr. So per’s dia gnosi s i n Patrici a’s m edi cal records and wrote t hat her CA T scan was

on “h old.” The defen dant contacted t he pla int iffs b y t ele ph o ne t o as k s o me fol low-up questi ons about t he medi cal condi tions discl

ose d in the o rig inal a pp licat io n. On A pr il 20 , 2 00 4, t he p laint iffs compl eted an am en da tory en dor se m en t t o t he insur ance po licy. The a mendat or y endo rse ment contain ed the i nf or mat io n r eq ue st ed in t he t ele pho ne c all an d fu rt her re qu es t ed t hat t he p laint iffs reportany

il ln ess, i nj ury, or phy

si ci an consul

tation si nce the origi

nal appl i cation wa s su

bm i tted. The pla int iffs di

d n ot i n cl ude i n th e a men dm en t an y i n f orm ati on ab out P atr

i ci a’ s v i si ts to Dr. Cy

bor sk i or Dr. Soper , t hei

r diagnoses, or any pr esc ribed medicat ion. The defend ant co ndit ionally appr ove d t he pla int iffs for coverage ef fecti ve A pril 9, 2004. On Apri

l 20, 2004 , t he pla in tiff

s paid thei

r fi rst premi um f ort wo full mo nt hs o f co ve r ag e. On Ap r il 28 , 20 04 , t he de fen da nt be ga n r ec eiv ing cla ims f or P atr i ci a’ s m ed i ca l tre atm en t. On o rab o ut Ma y 19 , 20 04 , Pa t r icia wa s d iag no se d w it h p r o ba ble peri toneal or ovari an can cer. The defend ant examined t he cl ai m s a nd f oun d c ond i ti ons an d c i rcu m sta nc esnot l i ste d on t he app licatio n. The defend ant t hen co nt act ed t he plaint iff s t o o bt ain a

l i st of the i r m edi cal prov i de rs f or t he pa st 1 0 y

ea rs . Th e def en da n t com men ce d a con testi b i l i ty invest igat ion and bega n examining the1-06-1203

5

plai ntif fs’ clai ms. Under speci fi

c circumstances, t he de fendant co nduc t s co nt est ibil ity invest igat ions wit hin t he first 24 mo nt hs o f a po licy to det er mine it s lia bilit y un de rt he co nt r ac t . Du r ing t his in vest igat ion, the defendant request ed Pat ricia’s m edical recor ds from her treat in g phys ici ans. Acco rd ingto the

af f i da vi t of Su san Yeazel , director of mem bers’ s ervices f

or Hall ma rk Servi ces Corp orati on (Hall mark), a wholly

owned su bs i di ary

of H ealt h Car e Se rvice C or po ra t ion, t he defen dant exam

in ed t he medica l reco rd s and fou nddiscr epa ncies bet wee n t he medica l reco rd s and the a ppl i cation. Af ter examining the medical re co rd s, t he de fendant dec ided t o r esc ind t he pla in tif fs ’ i nsuran ce po licy. The de fen da nt co nc lud ed t ha t t he fals e a nsw er s “s ub st an t ially increa sed t he cha nces of t he
even ts insured agai

nst.” Yeazel

expl ai ned i n he r aff ida vi t t hat a poli

cy would not hav

e been is sued to t he pla int iffs if a cc ur at e in fo rmat io n ha d b ee n d isc lo sedin either t he o riginal ap plicat ion o r t he
am endatory endo rse ment. Yea zel fur t her st at ed t hat t he plai ntif fs ’ appl ic ation contai

ned m aterial misrepresentat ions, and in ac co rd ance wit h co mpany po licy, the defend ant t her efo re re scinde d t he i ns uran ce pol i cy ef f ecti ve Apri l 9, 2004 , and ref

und ed al l prem i ums to the pl

ai ntif f s. On De cember 14, 200 5, t he plaint iff s filed the ir t wo -c ou nt co mplaint se eking t o ha ve t he policy re insta t ed a nd da mages for t he de fen dant’s al le ged breach

of contract. T he def

endan t later fi le d a mot ion fo r su mmary judgment . As e xhibits in sup po rt of it s mot ion, t he de fendant in cl uded t he origi nal i ns uran ce a ppl i cation, the

am endatory endorsem

ent, the insurance pol

ic y, m edi cal records f rom Dr. Cyborski and Dr. Sop er, t he Bl ue Cross Blue Shiel

d rescissi on l etter, a let t er t o Pa t r icia Co nt i, and t he affidavit of S usa n Yea zel. The defend ant ar gue d t hat t her e wa s no genui ne i ssueof
ma terial fact regar di ng w hether the statem

en ts Patricia m

ade on her appl i cation we

re bot h false and1-06-1203

6

material
. The defen dant argued that the plai

ntif fs in tentional ly fal si fi ed thei r insurance appl

ic ation when they omi tt ed Patricia’s March

25, 2004 consultation wi th Dr. Cyb orski an

d fai le d to in cl ude her subs equ ent ph ysic ian visit s a nd dia gn o sis in t he am endatory en

dorsemen t. The defen

dant contended that Patricia’s m

edi cal records clearl

y de mons trat ed that she consul

ted with a ph

ys ic ia n on March

25, Ap r il 1, and April

8, was diagnosed with probable di verticuli tis, and presc r ib ed Prot onix and a
com pl ete ten -d ay cou rs e of an ti b i oti cs . Addi

ti on al l y , the rec ord s c l ea

rl y demon strated t hat t he pla int iffs knew of Patri ci a’s m edi cal condi tion, but f ail ed to di scl

ose the material f acts. The defend ant co nt ende d t hat t he plaint iff s’ misrep re sent at ions we r e ma t er ial a nd t ha t it wo uld have nev er is sued
a pol i cy of insu r an ce if

Patr i ci a’ s m edi cal con di ti on h ad be en di sc l ose d i

n th e ori gi na l appl i ca ti on or am endatory endorsem

en t. T he pla int iff

s filed a r es po nse and a c ro ss -mo t io n fo r s ummar y jud gme nt . T he p laint iffs argued t hat t hey tr ut hfully

answ er ed t he que st ions in bo t h t he o riginal ap plicat ion and t he am endatory
en do r se me nt to th e b est of th ei r k n owl ed ge an d b el i ef . In su pp ort of th ei r m oti on , the p l ai

n ti ff s in cl uded their own depositions, t he or iginal insuranc e ap plicat ion, t he amend at or y endo rse ment, t he depos i ti on of G lor ia Pfaff, a t echnica l under wr iter for Hallmark , t he depositi on of Susan Yea zel, t he depos i ti on of Peter Fi scher, m

anager of b enef

it serv ic es f or Hall ma rk Servi ces Co rp or at ion, t he risk manage ment com

m i ttee ’s ev al ua ti on of the pl ai nti f f s’ ca se , an

d un de rwr i ti ng gui de l i ne s f or di vertic uli tis
. Inthei r c ro ss- mot ion fo r su mmary judgment , t he plaint iff s ar gue d t hat t he langu age in th e que st ions was ambiguo us a nd there f ore sh oul d be construed ag ai

nst the i ns urer. In he r d epo sitio n,1-06-1203

7

Pa t r icia testifi

ed that “somethi

ng was wrong”

wi th her; how ever , she t est ifi ed t hat she d id no t t hink her condi tion qual if ie d as a n il lne ss. Donal d al so test if ie d in hi s deposition that based on hi s own de f i ni ti on of c onsu l tation , Patricia’s

doctors vi si

ts were not co nsult at ions be cau se c ons ult at ions must be based on a s

peci fi c i ll ness , and that hi s wi fe was not il l duri ng the appl

ic ation proces s. The pla int iffs al so of

fere d t he t est imony of Su san Y eaz el and G lor ia Pfaff. Y eaz el te st ifi ed t hat t he defend ant did not have a standard ized def in ition of the terms “i

ll ness”and “ checkup.” Pf

aff testifi ed that t he de fendant ’s und er wr iting g uidelines d id no t mandat e t hat t he plaint iff s’ co ver age be term i na ted but, rathe

r, sug ges ted tha

t the pl ai ntif f s pa y a hi ghe r prem i um f or cover age. The trial court granted

the de f en da nt’ s m oti on f orsum ma ry j udgem

ent and concl

uded that t he pla int iffs’ an sw er s w er e ma t er ially fa lse as a ma tter o f law. T he t rial co ur t fou nd t hat no r ea so na ble pe r so n u nd er t he fac t s o f t his c as e c o uld co nst ru e Pa t ricia’s d oc t or s visits t o be anything ot her than a ph ys ic al exam in ation unde

rt he pla in a nd o r din ar y mea ning s o f t he t er ms “chec kup ” and “c o nsu lt at io n.”

T he co ur t als o he ld t ha t no r ea so na ble pe r so n u nd er t he fac t s o f t his c as e w o uld be l i ev e tha

t a pers on wh

o had f i ve doctors vi si

ts wi thi n th ree w eeks f or severe abdom

in al pai n was anything ot her

t han ill. The t rial co ur t re lied on Golden Ru l e In su ra n ce Co. v . Sc h wa rtz , 203 Ill . 2d 456, 467, 786 N.E.2d 1010, 1017 (2003 ), in holdi ng that t he pl ain

tiff s’ statements were false as a
ma tt er of law. Addi

tional ly , the court hel

d that t he f

al se sta te ments wer e mat er ial, base d o n t he
a ffi da vit of Y eaz el, in which she st at ed t hat t he ap plicat ion wo uld have been d eclined ha d t he i ns uran ce c omp an

y know n the true status of

Patricia’s he al th. The pl ai n ti f f s h av e p rop erl y appe al ed pu rsua n t to Su pr em e C our t R ule301 (155 Ill. 2d R. 301).1-06-1203

8 AN AL YSIS On ap pe al, t he pla int iffs a r gu e t ha t t he in su rance appl ic ation contai

ned am bi guities that preclude d sum mary judg ment in favo r o f the de fen da nt . T he y co nt en d t ha t t he t r ial c o ur t er r o ne o us ly he ld that t he termi

nology in the defe ndan t’s policy was plai n an d ordinary

and sus ceptib le

only to an i nte rpreta ti on aga inst insu ra nce c ove ra ge. The pl ai n ti f f s c l ai m th at th ey answ ered

th e q ue sti on s to t he be st o f t he ir k no wle dg e a nd be lief. T he y bo t h be lieve d t ha t Pa t r icia su ffer ed fr o m o nly a stomachach

e and was not affli ct ed w ith anysic kn es s, di se as e, di so r de r , co nd it io n, illne ss o rinju ry. The pl ain t iffs als o ar gu e t ha t at t he t ime t he y co mp let ed t he o r ig ina l ap pl ica t io n, t he y were not adv i sed of a ny pen di ng or s ugge sted trea

tme nts or tests. Addi tional ly , the plai ntif fs contend that t he t er m “co nsu lt at io n” is a mbig uo us an d s us ce pt ible to m oreth an on e m ea n i n g. Th e p l ai

n ti f f s c l ai m th at P atr i ci a’ s s ub se qu en t doctorsv i si

ts ( af te r th e in itial Mar ch 25 visit) wer e no t co nsult at ions be caus e the y both b el i ev ed a “cons

ul tation ” occu rs after
a patien t is i nf ormed of h

is or her il ln ess an d then di sc us se s wi th th e trea ti n g p h y si ci an h ow to treat t he ailment. The pla

in tif fs argue that they

hon es tl y be l i eved tha t Patr i ci a di d n ot con sul t wi th a doc tor be ca us e she wa s n ot sick a nd had only a minor st omac hache . T he pla in tif fs al ternativel y a rgue that
ev en if t he court f

i nds that the repre sen tations we

re f al se, the court erre d by

f i ndi ng th at they were mat er ial. Th e p laint iffs con ten d that a j ury sh oul d de term i ne whether th

ey l i ed on th e a ppl i ca ti on and then determ i ne wh ethe r the re pres en tations we

re m ateri al
. Sum mary judgm ent is appropriate “if the pl

eadi ngs, deposi

tions, and ad mi

ssions on f

il e, to gether wit h t he affid av it s, ** * s ho w t ha t t he r e is no genui ne i ssue as to any

ma terial fact an d that t he movi ng party is enti

tled to judgm ent as a m atter of law.” 735 ILCS 5/2-10 05(c) (We st 2002 ).1-06-1203

9

We review a

trial cou rt’ s or der of su m mar y j udgm en t de novo
. Pe kin I nsu r an ce Co . v. Ad ams , 343 Il l . Ap p. 3d 27 2, 275, 7 96 N.E.2 d 175, 1 78 (20 03). Se cti on 15 4 of th e In su ra n ce Cod e state s i n perti n en t pa rt: “No m i srep res en tati on or fal se warranty

ma de by the in sured
o r in his b ehalf i n the negoti ati on f

or apolicy

of i nsuran ce, or breach of a c ond i ti on of such pol i cy sh al l de f ea t or av oi d the p ol i cy

or pr event its attachi

ng unl ess such m i srep re se n tati on , f alse wa rra n ty or con di ti on shall have be en st at ed in

the policy

or endorsemen

t o r rider attachedthereto , or in the wri tt en appl ic at i on therefor. No such
m i sre pre senta

ti on or fal se warranty

shal l de feat or avoid the pol

ic y unl ess it sha ll have been m ade wit h ac tua l i nte nt to d ec ei ve or mat er ially af f ec ts e i th er th e acc ep tance of the ri sk or the ha zard
ass um ed b y the c omp an

y .” 215 ILCS 5/154

(We st 2002 ). If “‘[the i nsurer] [chooses] to incl

ude l anguage

in its group in

surance en

roll me nt form that ha[s] the eff

ect of shi fti ng the f ocus, in a determi nation of the t r ut h o r fals it y of an appli cant’s sta tem en t, f rom an i nqui ry i nto whether the facts assertedwere true t o whether, on the basis of wh at he knew, the appl

ic ant bel ie ved them to be true,” “then, the appl ic ant’s answer m

ust be asses sed

in t he li ght o f his act ual knowledge. ’” Gol den Ru l e In su ra n ce Co. v . Sc h wa rtz , 203 Ill . 2d 456, 465, 786 N.E.2d 1010, 1016 ( 2003), quot in g Ski n n er v . A etn a L i f e & Ca sual ty , 804 F.2d 148, 150 (D.C. Ci r. 198 6) . T he de t er mini

ng fact or in judging t he validity o f an app licant’ s ans wer is w hat t he applic ant in

fact bel ie ved to be true. Gol

de n R ule In su ran ceCo. , 203 Ill . 2d at 465, 786 N. E.2d at1-06-1203

10

1016, ci ting Skin ner , 804 F.2d at 150. Ho wever, a court may fi nd an appl

ican t’s stat emen

t false as a mat t er o f law if t he st at eme nt is clearl y contrad i cted b y f acts. Golden

Rul e Insuran

ce Co. , 20 3 I ll. 2d at 465, 786 N.E .2d at 1016, citing Skin ner , 804 F .2d at 15 0. To establ is h whether an

in surance pol

ic y s hould b e voi ded, the court looks at (1) whether t he st at ement ma

de was f al se, and (2) i f the f

al se statemen

t was made

wit h a n i

nte nt to d ec ei ve or mat er ially af f ect the acc eptan ce of the risk or haza

rd as sum ed b y the i ns urer. Golden

Rul e Insuran

ce Co. , 20 3 I ll. 2 d a t 46 4, 78 6 N . E . 2d at 10 15 . An in su rance com

pan y may voi d a con tract f or a ma terial mi srepresentation i

f the m is repres ent ati

on i s “ ‘m ad e wi th a ctu al i nte nt to d ec ei ve or mat er ially aff

ects e ither t he accept ance of t he risk or the hazar d assumed by the company.’” Kohl me ie rv. Shel ter In su ran ceCo. ,1 70 I ll. App. 3d 6 43, 652 , 5 25 N .E .2 d 94 , 1 00 ( 198 8) , q uo t ing I ll. Rev. Stat. 198 3, ch. 73, pa r. 7 66. A l ay pe rs on a ppl y i ng f ori ns ura nc e i s n ot expected to answer que st ions conc ern

i ng h i s pa st or pres en

t hea l th status wi th the ski l l of a trai ne d ph y sician . Kohl

me ie r , 170 Il l . Ap

p. 3d a t 652, 525 N.E.2d a

t 101. A n i nsur ed i s n ot req ui red to di sc l ose

i nf orm ati on be y ond the kn owl edgeof an ordi na ry pe rs on i f he has n ot be en info rmed ab o ut his c o nd it io n by his doctor. Kohl

me ie r , 170 Il l . Ap p. 3d a t 652, 525 N.E.2d a

t 101. The t er ms a nd co nd it io ns o f an in surance co nt ra ct will be enfor ced as t hey app ear if the la nguagei s un

am bi guous. Gol

de n R ule In su ran ceCo. , 203 Il

l . 2d at 46 5, 786 N .E.2d at 10 16. The la nguageof

th e c on tra ct is c on si

dere d a m b i gu ous i f i t i s s us ce pti bl e to more than one m

eani ng. Am erica n St at es I nsur ance Co . v. Ko lo ms , 177 Il l . 2d 473 , 479, 68 7 N.E.2d 72, 75 ( 1997)
. Am bi guous la nguage i n an in surance contract wil

l b e strictl y c onstrued against the insurer that drafted the p oli cy . A meri ca n S tate s Ins

ura nc e C o. , 177 Ill . 2d at 479, 687 N. E.2d at 75.1-06-1203

11

In thi s c as e, th e p l ai nti f f s f i l l ed out the i ns ura nc e a ppl i ca ti on and am endatory en dors em en t f or h ea l th in surance and om itted in form ation regardi

ng Patrici a’s stomach

ai lm ent, physi ci an

visits a nd any prescrib ed

medicat ion. The t rial co ur t fou nd t hat t he statem en ts provi ded b y the p l ai ntif f s we re false as a matt er of law . T he insur ance app licatio n spe cifically re que st ed info rmat ion r ega rd ing Pat ricia’s heal th, frequency of phy

sici an visits, pe ndin g t es t s a nd p re sc ribe d me dic at io n. Th e p laint iffs fai le d t o includ e any infor matio n re gar ding h er sto mach ai l men t. Pa tri ci a’ s m ed i ca l re cordssta

te that she vi si ted Dr. Cyborski

and Dr. Soper mul

tiple tim es fo rt r ea t men t wh ile he

r i ns ura nc e a ppl i ca ti on was stil l pe ndi ng approval . The m

edi cal records also i

ndicate that Pat rici

a i nf ormed Dr. Soper t hat she had no med

i ca l i n su ra n ce , di d n ot wish to be h ospitaliz ed or undergo a CAT scan an d requested that h e “ tre at her co nser vat ively.” The se r eco rd s clear ly cont ra dict t he ans wer s su bmitt ed by t he pla int iffs f

or question

3(f ), 4, 5, an d 9, wh i ch we h av e prev i ousl y ci ted. T he pla int if

fs in deed had knowle dge of P at ricia’s illness and need f or further medi

cal tests, but fail

ed to incl ude the i nf orm ati on i n the i ns uran ce a ppl i cation. The pla int iffs argue that the lan guage contain

ed i n the i nsuran ce co nt ra ct was ambiguo us a nd sho uld be construed agains t t he d efe nda nt . T he p laint iffs cont end that they did not beli eve Pat ricia’s doctors vi sits constitut ed “consultations” becausethey did not con sider Pa

tric i a il l
. Patricia vi si

ted b oth Dr. Cyb orskiand Dr . S op er multiple t imes while her a pplicat ion wa s pe nding ap pr ova l. Du ring these vi si ts, t he m edi cal records show that Patrici a was diagnosed wi th possib le

div erticul iti s, advi sed to un de r go mult iple testing, and was prescri bed a seri es of drugs, i

ncl udin g antibiotics . Oursu pr eme court hashe ld t ha t an ap plic an t ’s pr o fes se d b elie f in t he t rut hfu lne ss o f he ran sw er s is not sufficient to enfo rc e t he c o nt ra ct if act ua l kno wle dg e c lea rly c o nt ra dic t s t he b elief. Golden Rul e Insuran

ce Co. ,1-06-1203

12

203 Ill . 2d at 467, 786 N. E.2d at 1016, ci ting Sk inner v. Aet na L ife & Ca sual ty , 804 F.2d148, 151 (D.C. Cir. 198 6) . We agr ee w ith t he tri al cou rt an d f i nd tha t no rea son

ab l e p ers on

could construe Pat ricia’s mult iple doctorsv i si

ts t o be anything o t her t han a p hysical examinatio n unde r t he plain and ordinary me ani ngs of the terms “ checkup” an

d “consul tation.” We al so fi nd that these m

is representations b

y the pla in tif fs ma terial ly aff ected the acceptance of the ri sk or hazard assum ed by the defe ndan t. Yeazel’s

aff ida vi t clearl y s tates t hat t he defend ant wo uld have deni

ed coverage if

Patricia’s f

ull me dic al hi story had b een disclosedin the a pplicat ion. T his co ur t held in Garde v . C oun try Li f e In su ran ceCo. , 147 Ill . App. 3d 1023, 1032, 498 N.E. 2d 302, 309 (1986), t hat an

insu re r’ s e mplo yee o r u nde rw rit er may t es t ify to es tab l i sh

the material i ty of
a misrepr ese nt at ion. The co ur t furt her held t hat t he qu es t io n o f material i ty i s a ppr opri atef or sum mary judg ment if t he mi

srepresentation is of such

a nature that all

would agree that

i t i s or i s n ot mat er ial. Garde , 147 I ll . App. 3d at 10 32 , 49 8 N . E . 2d at 30 9. We find t ha t Ye az el’ s a ffida vit
su fficie nt ly

es tab l i sh ed tha t the de f en da nt woul d n ot hav e a pp r o ve d t he pla int iffs’ ap plic at io n if Patricia’s m

edi cal condi tion had b een f

ull y di sclosed. The t rial co ur t pr op er ly f

ou ndt ha t t he pla int iffs’ st at eme nt s in t he iri ns uran ce a ppl i cation we re false as a m atte r of l aw an d m ate rial l y af f ec te d the de fen

dant’s decisi on to approve coverage. Ac cordi ngl y , we af f i rm the orde r of th e ci rcui t court of C ook County
. Af f i rmed. QUINN , P.J., an

d THEIS, J ., conc

ur.