Some insurance companies do not cover certain treatments if they believe that the treatments are experimental, even if such treatment may save someone from cancer. For the health care company Aetna, this hesitation had costly consequences.
While Aetna is being held accountable for their behavior, hundreds more across Oklahoma suffer due to the poorly planned policies of insurance companies. If you’ve been the victim of your health insurance acting in bad faith, contact the bad faith attorneys at Kent McGuire Law today.
Aetna Fined for Client Death
$25.5 million was given to a grieving family after a case was settled with Aetna after it refused to offer any discounts or coverage for what the company considered an experimental treatment for cancer. Ron Cunningham’s wife, Orrana, was diagnosed with stage IV nasopharyngeal cancer on her brain, optic nerves, and part of her brainstem.
MD Anderson in Houston, Texas recommended proton therapy. The treatment could have more precisely killed the cancer without damaging surrounding areas.
These precautions are especially important and beneficial for cases of brain cancer as brain cells and neurons are the only cells in the entire human body that cannot grow back. Any other treatments would have significantly increased the chances of brain damage that could impair vision, memory, and other functions.
The Cunninghams took this treatment option but were surprised to find that their insurance company refused to cover the treatment. Aetna stated that it considered proton therapy to be an experimental treatment not covered under the family’s policy.
Despite this burden, the family pursued the treatment with Ron paying for the entire treatment out-of-pocket. Regrettably, the treatment was not successful, and his wife passed away soon after from herpetic encephalitis.
The verdict was the biggest bad faith insurance verdict for an individual case in Oklahoma history.
“It was certainly a stunning verdict to award that much money, and it was a message, too,” Oklahoma personal injury attorney Kent McGuire said after the conclusion of the trial.
The jury determined that Aetna “recklessly disregarded” Orrana’s case, a statement that comforted Orrana’s husband Ron.
“When they said that, it was like, ‘I think we did her proud,’ ” Ron said.
Bad Faith & Breach of Contract
As with the case against Aetna, an insurance company is considered to be acting in bad faith when it negligently fails to provide coverage for treatment. This negligence can be due to bias, lack of training, or general disregard for a client. This behavior may result in further injury, debt, or death of the client if treatment is not sought due to financial issues.
Aetna was held accountable on the charges of bad faith and a breach of the insurance contract. Aetna had coverage for proton therapy but failed to inform the Cunninghams of this discovery. The Cunninghams could have received coverage, but the insurance company did not act in a timely manner and withheld information. Such behavior can have life-altering consequences for those who need this coverage the most.
When You Should Seek Lawyer Help
If you ever experience a situation in which a life insurance or health insurance company withholds information, refuses to compensate you for a legitimate claim when you provided sufficient evidence to back up that claim, or if an insurance company delays a claim longer than necessary, then you should talk with an insurance lawyer because this is not professional behavior.
Oklahoma Bad Faith Attorney
If you believe that a health insurance company has wronged you in a way that has led to expensive medical bills or damaged to your health, contact the Oklahoma bad faith lawyers at Kent McGuire Law. We can assess your situation and determine a path forward to ensure you obtain fair compensation for any damages. Contact us today at (405) 513-5658 for a free consultation