CA teen's family sues Cigna over transplant

[cougarnurse]

OK....knew this would come up again: Calif. teen's family sues Cigna over transplant - Yahoo! News

The family of a 17-year-old leukemia patient has sued health insurance giant Cigna Corp. for her death in 2007 after the company initially refused to pay for a liver transplant.

The lawsuit filed last week in Los Angeles County Superior Court by the family's attorney, Mark Geragos, alleges breach of contract, unfair business practices and intentional infliction of emotional distress. The suit accuses Cigna of delaying and rejecting valid claims, which resulted in the wrongful death of Nataline Sarkisyan.

The Philadelphia-based insurer eventually approved the transplant after Sarkisyan's family held a rally outside Cigna's suburban Los Angeles office. Nataline, however, died hours after the approval was secured.

Chris Curran, a spokesman for Cigna, said the company empathizes with the family but feels the lawsuit is without merit. Curran said Cigna volunteered to pay for the procedure out of its own pocket and not the employer's.

"This decision was made despite the fact that Cigna had no obligation to do so and despite concluding, based on the information available, that the treatment would be unproven and ineffective and therefore experimental and not covered by the employer's benefit plan," Curran said, reading from a statement.

But Charles Idelson, a spokesman for the California Nurses Association, said insurance companies are "in business to provide profits for shareholders, not to provide care."

"Nataline Sarkisyan's case serves as a tragic poster child for everything that's wrong with our insurance based health care system," he said. "Why did it take public humiliation for Cigna Corporation to approve a transplant?"

Nataline was diagnosed with leukemia at 14 and received a bone marrow transplant from her brother the day before Thanksgiving 2007. A complication, however, caused the teen's liver to fail.

The family had asked Cigna to pay for a liver transplant but the insurer refused, calling the procedure experimental.

In a subsequent letter to Cigna, four doctors from Mattel Children's Hospital at UCLA Medical Center appealed to the insurer to reconsider.

They said patients in similar situations who undergo transplants have a six-month survival rate of about 65 percent.

The insurer eventually reversed the decision while about 150 nurses and community members rallied outside its office in Glendale.

By this time, however, the teen had fallen into a vegetative state and was taken off life support. She died within the hour.