OKLAHOMA CITY (AP) — A jury has ordered Aetna to pay greater than $25 million to the circle of relatives of an Oklahoma City girl who died a yr after the insurance coverage corporate refused to hide one of those radiation treatment.
Jurors discovered that Aetna medical doctors didn’t spend sufficient time reviewing Orrana Cunningham’s case ahead of denying her protection for proton beam treatment in 2014, The Oklahoman reported. The jury dominated that Aetna recklessly brushed aside its responsibility to deal relatively and in excellent religion with Cunningham, who had nasopharyngeal most cancers.
Aetna is thinking about whether or not to enchantment the ruling, which used to be issued this week. Company legal professional John Shely mentioned the insurer tries to do the suitable factor.
“If it’s in our control to change, that’s what we’re going to do,” Shely mentioned. “Aetna has learned something here.”
An Aetna physician denied Cunningham protection for the treatment in 2014, deeming it experimental. Two different in-house medical doctors reviewed and upheld the verdict.
The Food and Drug Administration had licensed proton beam treatment, which may be a remedy lined by means of Medicare, in line with Doug Terry, the circle of relatives’s legal professional. He alleged that Aetna denied protection for monetary causes and that its medical doctors have been unqualified, overworked and biased when making choices. Court data display that one physician complained to the insurer about having to study greater than 80 instances an afternoon.
After she used to be denied protection, Cunningham and her husband made up our minds to loan their house in Meeker, about 35 miles (56 kilometers) east of Oklahoma City, to pay for the treatment in Texas. She died in May 2015 at age 54.
“My wife, her goal, was to make this fight,” Ron Cunningham mentioned. “Her comment was, ‘If we can save one person and stop Aetna from doing what they traditionally do on every claim, it was worth the battle.’”