Turner v. Milliman
392 S.C. 116
S.C.2011Background
- Turners sought health insurance and consulted Milliman about options and representations.
- Turner alleges Milliman stated a group policy via CBA would have stable premiums and broader coverage.
- Premiums for Turner's coverage rose dramatically from 1996 through 2001; in 2001 the policy was terminated and replaced with a similar-price policy with fewer benefits.
- Turner, due to diabetes, could not obtain alternative coverage; some correspondence suggested the product might be group, some suggested individual.
- Policy was issued through MidAmerica and reinsured/assumed by Provident Indemnity; certificate indicated group policy; some communications indicated individual coverage.
- Trial court granted summary judgment to respondents on several theories; the court of appeals narrowed some issues but left unresolved key questions about Milliman's representations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Are Milliman's statements about the policy being a group policy actionable as fraud or negligent misrepresentation? | Turner asserts false statements induced contract formation. | Defendants contend the policy was group and statements about future events are nonactionable. | Negligent misrepresentation survives; fraud claim remains nonactionable at summary judgment. |
Key Cases Cited
- M.B. Kahn Constr. Co. v. S.C. Nat'l Bank of Charleston, 275 S.C. 381, 271 S.E.2d 414 (1980) (elements of fraud claim)
- Sauner v. Pub. Serv. Auth. of S.C., 354 S.C. 397, 581 S.E.2d 161 (2003) (mere broken promise not sufficient for negligent misrepresentation)
- Davis v. Upton, 250 S.C. 288, 157 S.E.2d 567 (1967) (present or preexisting fact requirement; misrepresentation must be false when made)
- Adams v. G.J. Creel and Sons, Inc., 320 S.C. 274, 465 S.E.2d 84 (1995) (promises without intent to perform may constitute fraud)
- Woods v. State, 314 S.C. 501, 431 S.E.2d 260 (Ct.App.1993) (nonperformance of a promise requires supporting evidence)
- Coleman v. Stevens, 124 S.C. 8, 117 S.E. 305 (1923) (oral promises and intent at time of agreement)