Couple battle to make insurers liable for coverage decisions

Discussion in 'Healthcare/Insurance/Govt Healthcare' started by strollingbones, Oct 11, 2009.

  1. strollingbones
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    strollingbones Diamond Member

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    interesting read...they lost their daughter due to insurance refusing a liver transplant...then find out ....you are blocked from suing insurance companies and how protected insurance companies are....basically how the courts allow insurance companies to fuck their clients and let them die...

    Couple battle to make insurers liable for coverage decisions -- latimes.com

    By Lisa Girion - Surrounded by supporters, Hilda Sarkisyan marched into Cigna Corp.’s Philadelphia headquarters on a chilly fall day, 10 months after the company refused to pay for a liver transplant for her daughter.

    "You guys killed my daughter," the diminutive San Fernando Valley real estate agent declared at the lobby security desk. "I want an apology."

    What she got was something quite different.

    Cigna employees, looking down into the atrium lobby from a balcony above, began heckling her, she said, with one of them giving her "the finger."

    Sarkisyan walked out, stunned and hurt.

    "They showed me their true colors," she said. "Shame on them."

    Cigna later apologized for the 2008 incident, but it has now become -- unintentionally -- the central element of a lawsuit Sarkisyan and her husband, Grigor, are pressing against the health insurer.

    The suit began as a wrongful-death complaint, with the couple contending that Cigna's refusal to cover the transplant led to Nataline's death Dec. 20, 2007, in a case that drew national media attention.

    A Los Angeles judge threw out the wrongful-death complaint, saying it was barred by a 1987 U.S. Supreme Court ruling that shields employer-paid healthcare plans from damages over their coverage decisions.

    But U.S. District Judge Gary Allen Feess said the Sarkisyans could pursue damages for any emotional distress caused by the Philadelphia incident.

    The ruling was bittersweet for the Sarkisyans and patient advocates, who say it points to the need for federal legislation to allow people to sue health insurers for the life-or-death decisions they make.

    "They kill a beautiful 17-year-old girl, and I get to go after them for a finger? That's sick," Hilda Sarkisyan said.

    The Sarkisyans contend that Cigna improperly refused the transplant that Nataline's UCLA physicians said at the time was urgently needed to save her life, and that the company reflexively issued a denial letter without looking into the specific circumstances.

    The company said at the time that, for Nataline, the operation would have been experimental and was not covered. Nine days later, amid a storm of publicity, Cigna agreed to cover the transplant.

    It was too late. Nataline died hours later.

    read the full article.
     
  2. Modbert
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    Modbert Daydream Believer Supporting Member

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    Heartless bastards, deserve to lose every red cent to their victims.
     
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  3. JW Frogen
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    JW Frogen Gold Member

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    When you take out private insurance you are betting against yourself, and like any casino the HMOs have the odds figured out in their favor.

    Any actuary will tell you the more people in a health care plan the more effective it is.

    As in universal cover?

    Now I know the government can fuck that up, but still, why put all your ills in one basket, private or public?
     
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  4. RodISHI
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    RodISHI Gold Member

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    Many big insurance companies, mega corporates and big banks own most judges and many politicians. They all need to be stomped out.
     
  5. dilloduck
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    dilloduck Diamond Member

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    and the proper ratio of high risk to low risk members. The profit that now goes into the hands of private insurance companies will be gobbled up by government beauracracy if we go with socialized health care.
     
  6. alan1
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    alan1 USMB Mod Staff Member Supporting Member

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    I feel for the parents, but for them to claim the insurance company "killed" their daughter is bullshit. The child had recurrent leukemia and multiple organs were failing. The disease killed their daughter, not the insurance company.
     
  7. RodISHI
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    RodISHI Gold Member

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    But didn't the insurance company have an obligation to give their daughter that shot at life by paying for the procedure that could prolong her life? Or is it the insurance companies right to say she's going to die anyway why waste the money?
     
  8. dilloduck
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    dilloduck Diamond Member

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    Buying health insurance has NEVER meant that they will pay for everything possible to ensure that you have a long nor healthy life. It's a security racket that people fall for.
     
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  9. Emma
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    Emma Evil Liberal Leftist™

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    It's a fucking racket, I'll grant you that.
     
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  10. dilloduck
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    dilloduck Diamond Member

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    Sweet----I'm going to take that and run to the bank. :lol:
     

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