Stephen A. Wickland (West Virginia 1998)

Summary

The court held that occasional complaints of dizziness, without medical advice, diagnosis, examination, or treatment directed to the underlying condition, did not constitute a preexisting condition under the long-term care policy and governing statute. Because the medical records showed only sporadic dizziness complaints and no treatment or diagnosis of falls or vertigo during the six-month lookback period, the nursing-home benefits were not excluded. The court reversed the circuit court and remanded for entry of summary judgment for the administrator.

Holding

Standard of review for the Rule 59(e) appeal. The standard of review for an appeal from denial of a motion to alter or amend judgment under Rule 59(e) is the same standard applicable to the underlying judgment. Because the underlying judgment was summary judgment, the court reviewed the matter de novo.

Whether Hardman had a preexisting condition excluded by the long-term care policy. Periodic complaints of symptoms, without a health care provider rendering or recommending medical advice or treatment for the condition causing those symptoms, do not constitute a preexisting condition under the governing statute. Hardman's two dizziness complaints did not establish a preexisting condition because there was no examination, diagnosis, advice, or treatment for dizziness, falls, or vertigo during the six months preceding coverage.

Stephen A. Wickland

Summary

Holding

Cited authorities

Cited by