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Insurer sued for denying cancer patient’s insurance claim


Insurer sued for denying cancer patient’s insurance claim

| May 6, 2019 | insurance claims |

Insurance is designed to help people out during some of the most difficult times in their lives. Unfortunately, some insurers fail to pay out legitimate claims to policy holders in the interest of saving the company money. It can be difficult to hold insurers in Texas accountable, but doing so is important for all of the people that the insurance company is supposed to cover. One out-of-state attorney is doing just that after his insurance claim for cancer treatment was denied by his insurer.

The attorney, who is a survivor of prostate cancer, attempted to file a claim for treatment back in 2017. Doctors recommended a proton beam radiation therapy because it would be more effective and not as invasive as other options. His insurer, UnitedHealthcare, denied his claim to cover the treatment, saying that the treatment was experimental. The man countered that the treatment was approved by the U.S. Food and Drug Administration back in the 1980s.

The man was able to cover his treatment out-of-pocket, but he says he knows many people don’t have that option. He filed his lawsuit on their behalf, asking for UnitedHealthcare to pay anyone else who’d gotten the same denial for treatment. He has also pledged to donate any monetary damages to his local cancer institute. Three judges in the man’s case have had to recuse themselves from the proceedings; two because they were familiar with the attorney, and one because he was also a prostate cancer survivor.

No matter the outcome of this particular case, Texas families can see how important it is that insurance companies pay out claims to those who need them. Anyone who has had an insurance claim denied may wish to consult an attorney with the experience in this area of the law. It may possibly save a life.