Opinion ID: 1789301
Heading Depth: 1
Heading Rank: 2

Heading: Are the Policies Misleading?

Text: The commissioner urges that the policies of the Wisconsin Physicians Service are sufficiently misleading so that he was obligated in the furtherance of his statutory duties to require that the policies spell out the exclusion of the services of podiatrists in more express terminology. In our opinion, the policies are clear with regard to this exclusion,  and it would be inappropriate for the commissioner to require further definition by the appellant. We recognize that under secs. 148.03 (2) and 200.26 (6), Stats., the Commissioner of Insurance may, after a hearing and notice, withdraw his approval of any provision in an insurance policy even though he has previously approved thereof. This action may be taken if the provision is unfair, misleading, or encourages misrepresentation of the insurance contract. See also sec. 201.045 (1). Notwithstanding these powers, it would be error for the commissioner to require that the State Medical Society insert in its policies an exclusionary clause for podiatrists; the legislature in sec. 148.03 authorized the creation of a sickness-care plan wherein reimbursement would be limited to any medical or osteopathic physician licensed to practice in Wisconsin. The existing insurance policies reasonably follow the statutory language; they are not deceptive or misleading regarding the denial of reimbursement for the services of podiatrists. They may not be construed to provide benefits for the services rendered by podiatrists. By the Court.  Order overruling the demurrer to the answer reversed. Judgment reversed, and cause remanded with directions to enter a judgment granting declaratory relief to the appellant.