At Leopold & Associates, almost all of our cases deal with fighting insurance companies. Insurance companies are paid premiums to provide coverage, reimbursement and protection to people when things go wrong. We all know mistakes happen and we all also hope to be covered by insurance to help guard against the unforeseeable. Sometimes that can be reimbursement for medical expenses after a car accident or coverage for future medical care if a doctor makes a mistake. At its most basic, we carry health insurance to guard against catastrophic medical expenses such as a serious injury or cancer diagnosis. We count on the insurance that we, or an employer, pays for to cover those expenses. When an insurance company denies you coverage, trying to fight for your benefits you are entitled to while battling an injury or illness, can feel like fighting the weight of the world.
Last week, in a story similar tof John Grisham’s fictional book, and later movie, The Rainmaker, Aetna, one of the largest health insurance companies in the country was hit with a $25.5 million dollar verdict for denying lifesaving cancer treatment to an Oklahoma woman. As CNN reported, in 2014 Orrana Cunningham, was diagnosed with stage 4 nasopharyngeal cancer near her brain stem. Doctors wanted to treat the cancer with proton beam therapy, a common form of radiation. Aetna denied the claim arguing that this treatment was “experimental.” Orrana died of complications from the cancer in 2015 at the age of 54. Continue reading