December 27, 2008
The family of a 17-year-old leukemia patient has sued health insurance giant Cigna Corp. for her death last year 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 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 empathized with the family but believed that the lawsuit was without merit. Curran said Cigna volunteered to pay for the procedure. “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 Assn., said insurance companies were “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 healthcare system,” he said. “Why did it take public humiliation for Cigna Corp. 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. In a 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 underwent transplants had a six-month survival rate of about 65%. 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.