$25.5 million awarded to family of cancer patient denied insurance coverage
November 10, 2018
An Oklahoma jury awarded the family of a cancer patient $25.5 million after they determined they were denied coverage by Aetna. The jurors said the insurer acted 'recklessly' and the verdict is meant to be a message for Aetna to change their procedures.
This award may be the largest verdict in an individual 'bad faith' insurance case in the history of that state's legal decisions. In addition, it will likely result in major ramifications all across the country for a form of cancer treatment called proton beam therapy.
The case centered on a 2014 denial of coverage for a woman who was fighting stage 4 nasopharyngeal cancer. Her doctors intended to try proton beam therapy, a form of radiation that targets the tumor without the potential for side effects of standard radiation therapy. However, Aetna denied her coverage, calling the therapy experimental. The patient died in 2015.
After delivering the verdict, the forewoman for the jury said it was clear from expert testimony that proton beam therapy was not experimental at all. For more about this story, click here.
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