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Thread: Aetna ordered to pay 25mil for denying coverage

  1. #1

    Aetna ordered to pay 25mil for denying coverage

    https://www.cnn.com/2018/11/10/healt...-st=1541872647

    An Oklahoma jury has awarded $25.5 million to the family of a cancer patient denied coverage by Aetna, with jurors saying that the insurer acted "recklessly" and that the verdict was meant as a message for Aetna to change its ways.

    The award is believed to be the largest verdict in an individual "bad faith" insurance case in Oklahoma history, one court observer said, and could have major ramifications across the country for a form of cancer treatment called proton beam therapy.
    The case revolved around the 2014 denial of coverage for Orrana Cunningham, who had stage 4 nasopharyngeal cancer near her brain stem. 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.
    Aetna denied her coverage, calling the therapy investigational and experimental.
    However this is the real gem and I suspect this probably made a bit factor in the decision by the Jury.

    Aetna attorney John Shely said in closing arguments that the insurance giant was proud of the three medical directors who denied coverage, even turning to thank them as they sat in the front row of the courtroom, according to jurors and other witnesses in court.
    Really you are being sued for essentially sentencing someone to death in the name of profits and you are proud that you did so? That is not going to win a Jury.
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  2. #2
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    Delores Mulva's Avatar
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    Re: Aetna ordered to pay 25mil for denying coverage

    That, and the other thing noted in the article:

    Quote Originally Posted by Article excerpt
    She said jurors were turned off by one Aetna medical director who acknowledged handling 80 cases a day and by the fact that all three medical directors acknowledged they spent more time preparing for the lawsuit than on Orrana's medical case.
    Here's what Britain's NHS had to say about proton beam therapy in 2014:

    https://www.nhs.uk/news/cancer/what-...-beam-therapy/

    That gives some insight into the "experimental" angle Aetna used, especially when it's used for pediatric cases without being considered experimental. The small number of cases, at least at that time, did not allow for an analysis to determine if it was more or less effective than regular radiotherapy.

  3. #3
    Banjo Duellist, 8th Dan
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    Re: Aetna ordered to pay 25mil for denying coverage

    sigh, my poor old brains are flagging....
    during 1980s in USA it was exposed a particular health insurance company DELIBERATELY denied medical insurance claims, and of course got minimum punishment, sure they got a big fine, but whittle down, and NO ONE was criminally charged when they should have been done with mass murder

    bastards were linked with the "cover up psychs" like Wessely
    can't remember name of the damn corporation though, sigh


    *does some googling*

    UnumProvident
    that was the bastards!!!!

    and their shit has killed me
    (what do you think is gonna happen with denial of welfare, no medical treatment, constantly worsening pain etc? shame I can't get a rifle and put a .303 through the likes of Wessely, ATOS and Capita CEOs and every Tory MP mother fucker)

    https://dpac.uk.net/tag/unum-provident/

    https://www.sochealth.co.uk/2015/09/...lfare-reforms/

    more proof if any is needed that corporations should be made illegal on PAIN OF DEATH

    soon see how smug folk are about the faux-Capitalism we have when they get forked over and their countries wither and die along with their loved ones.
    Last edited by Silverblade-T-E; November 10th, 2018 at 04:27 PM.

  4. #4

    Re: Aetna ordered to pay 25mil for denying coverage

    I have already seen someone on another forum defend Aetna saying "They are a for profit company not a charity".

    Which to me proves in full the problem with the US healthcare system, For Profit and preservation of life do not belong together its why Police and Fire are a public service. I mean Imagine a crazy world where you had to have a "Protection Subscription" and a "Firefighting Subscription".
    "When you name your baby Jeeves...you've pretty much set up his career for life. You don't see many Hit Men, for example, named Jeeves. "Pardon me sir, but I must wack you now."
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  5. #5
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    Re: Aetna ordered to pay 25mil for denying coverage

    Quote Originally Posted by FilanFyretracker View Post
    I have already seen someone on another forum defend Aetna saying "They are a for profit company not a charity".

    Which to me proves in full the problem with the US healthcare system, For Profit and preservation of life do not belong together its why Police and Fire are a public service. I mean Imagine a crazy world where you had to have a "Protection Subscription" and a "Firefighting Subscription".
    Remember that scene from Gangs of New York?
    Before 1849 Firefighters in the US were all either 'for profit' or volunteers, resulting in fights between rival Firefighter "companies", firefighters starting fires themselves to make a profit etc.
    It's just that the US healthcare service never left the 19th century for one reason or another.

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    Banjo Duellist, 8th Dan
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    Re: Aetna ordered to pay 25mil for denying coverage

    The "fire brigades" in England became notorious for exactly such things
    You will notice old buildings in London with peculiar motiffs, like a "Sun" or such, plasterworks or castings about 2' or 3' across
    those showed which fire insurance service backed them...and thus who WOULDN'T help


    fireplaque.jpg


    unofficially the firemen, being decent Human Beings, started helping any fires and after several terrible disasters the government finally stepped in in the 1800s and forced fire service to be a Public body

    Millions of Americans have suffered and *died* because of your lunatic greedy health system
    the actions of monsters like Hitler are kind of obvious and folk fight against them, but as I keep saying, the corporations are *worse* because they are "eternal", have absolutely no responsibility (especially since nowadays they make sure the execs control share voting) and are as amoral as a psychopath


    oh and Trump's latest remarks about the Californian fires....the man is SCUM
    also, again as I warned ages ago back when we still all played Everquest, the fires and chaos global warming will bring are going to be colossal
    and what pisses me off are the so called "Christian" scum who want this who cheer it on, so they can have their "Rapture"...throw them in the fucking flames and let 'em barbeque, see how they like that (and that isn't a joke, way too many of those freaks, and way too powerful....goes all way up to the V.P.)

  7. #7
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    Re: Aetna ordered to pay 25mil for denying coverage

    There's still places where the "for pay" model of fire fighting applies, or at least it did in 2010:

    http://www.nbcnews.com/id/39516346/n...let-home-burn/

  8. #8
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    Re: Aetna ordered to pay 25mil for denying coverage

    Quote Originally Posted by Silverblade-T-E View Post
    sigh, my poor old brains are flagging....
    during 1980s in USA it was exposed a particular health insurance company DELIBERATELY denied medical insurance claims, and of course got minimum punishment, sure they got a big fine, but whittle down, and NO ONE was criminally charged when they should have been done with mass murder

    bastards were linked with the "cover up psychs" like Wessely
    can't remember name of the damn corporation though, sigh


    *does some googling*

    UnumProvident
    that was the bastards!!!!

    and their shit has killed me
    (what do you think is gonna happen with denial of welfare, no medical treatment, constantly worsening pain etc? shame I can't get a rifle and put a .303 through the likes of Wessely, ATOS and Capita CEOs and every Tory MP mother fucker)

    https://dpac.uk.net/tag/unum-provident/

    https://www.sochealth.co.uk/2015/09/...lfare-reforms/

    more proof if any is needed that corporations should be made illegal on PAIN OF DEATH

    soon see how smug folk are about the faux-Capitalism we have when they get forked over and their countries wither and die along with their loved ones.
    Mutual of Omaha did the same thing.
    For copyright purposes, all of my posts are covered under the "Do What The Fuck You Want To Public License"
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    Noone should sue or be sued ambiguously.

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