Aetna to pay $25.5M after denying cancer coverage
Health insurer Aetna must pay $25.5 million to the family of a cancer patient who was denied coverage by the company for treatment.
Jurors stated the insurer acted “recklessly” in its decision to deny coverage for Orrana Cunningham, who had stage 4 nasopharyngeal cancer, CNN reported.
“Her doctors wanted her to receive proton beam therapy, a targeted form of radiation that could pinpoint her tumor without the potential for blindness or other side effects of standard radiation,” CNN reported. “Aetna denied her coverage, calling the therapy investigational and experimental.”
Cunningham died in May 2015, and her family subsequently sued Aetna.
During the case, an Aetna medical director acknowledged handling 80 cases per day, and three medical directors reviewed Cunningham’s case and denied her coverage of proton beam therapy.
Jurors were clear the verdict and award to Cunningham’s family was meant to send a message to Aetna, according to CNN.
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Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."