Insurance Giant Aetna Slammed With $25.5 Million Bad Faith Jury Verdict

Aetna

Insurance is a critically important financial safety net for most Americans. People pay into a system that will protect them financially in the event of a disaster or catastrophic medical treatment. However, this system only works if insurance companies honor their agreements. When insurers face large claim payouts, they sometimes resort to inappropriate tactics to minimize claims and wrongfully deny payouts. But policyholders were handed a powerful win recently when insurance giant Aetna was slammed with a $25.5 million jury verdict for wrongfully denying coverage for cancer treatment.

In 2014, Orrana Cunningham was denied coverage for treatment of her Stage 4 nasopharyngeal cancer located near her brainstem. Because of the cancer’s location, ordinary radiation therapy would cause blindness, memory loss, and other debilitating side effects. Her doctors instead recommended a targeted form of radiation called proton beam therapy.

Mrs. Cunningham was denied coverage for proton beam therapy because Aetna deemed the treatment “experimental” and therefore not covered under her policy. However, as expert witnesses explained during the recent jury trial, proton beam therapy has been used successfully for decades, hardly making the treatment experimental.

Radiation oncologist Dr. Andrew L. Chang explained it best when he told the jury, “Proton therapy is a well-established treatment for cancer and has been for decades. … Nobody in the oncology community considers proton therapy experimental for the treatment of cancer.” Dr. Chang also pointed out that Medicare covers proton beam therapy, as do most pediatric plans for patients up to 21 years old. If insurance companies covered the cost of this treatment for patients under 21 and over 65, what exactly makes it experimental for those between the ages of 22 and 64?

Nothing does, according to an Oklahoma jury. Mrs. Cunningham died in 2015, and an Oklahoma jury believed it was important to send Aetna a message, awarding $25.5 million in damages to Mrs. Cunningham’s spouse. One might think the verdict would give Aetna a sense of responsibility or remorse. But unfortunately, lesson about bad faith insurance denials, but this is unlikely. Mr. Cunningham reported that after the verdict was read aloud in the courtroom, Aetna’s lead congratulated him on the verdict before telling him he would lose on appeal.

Insurance Companies Prey On Policyholders

Insurance companies rely on uninformed policyholders. Most policyholders are completely unaware of their rights and the actions they can take against insurance companies operating in bad faith. Insurance companies are aware of this, so they often utilize bad faith tactics hoping they don’t get caught – because most of the time they don’t. This is wrong, and every policyholder has a right to stand up to insurance companies that wrongfully deny claims. Whether you own a commercial property insurance policy or health insurance policy, you deserve full coverage.

Fight Back With Raizner Law

At Raizner Law, our experienced insurance lawyers pursue claims against insurance companies that deny cancer treatment. If your insurance company is delaying, undervaluing, or outright denying your claim for medically necessary cancer treatment, contact us today to see how we can help. All of our consultations are free and we work on a contingency fee basis, meaning there is no upfront cost for working with us, and you won’t owe us anything unless we help you recover compensation.

Sharing is caring!