Jurors Award $25.5 Million in Denied Cancer Treatment Lawsuit
“We Wanted to Send a Message to Aetna to Fix the System”
One of the jurors in the Cunningham case gave the above quote to a local reporter following the verdict. It was very gratifying to us and to Mr. Cunningham. We brought this lawsuit in an effort to change the health insurance system so it will be more fair to the ordinary person. Mr. Cunningham knows the long and difficult road he traveled made the jury believe Aetna’s system is broken and needs to change. Thankfully, that makes it clear his determination and sacrifice was worth it. The evidence proved Aetna’s system is in fact broken, and we are hopeful verdicts like this one will encourage them to fix it.
Jurors sent a clear message to Aetna with the $25.6 million award. The amount awarded for actual damages was $15.5 million with an additional $10 million for punitive damages. The case may make Aetna change its claims review process.
We take on insurers that don’t provide the coverage their policies include. If you think an insurer wrongly denied your cancer treatment, give us a call at (405) 463-6362 to schedule your free consultation today.
Jury Awards Millions to Family After Aetna Refuses to Cover Cancer Treatment
What Did Aetna Do?
Mr. Cunningham alleged Aetna designed its claim decision-making system so that it works against their policyholders.
In Aetna’s system, the evidence showed, unqualified nurses and doctors make claim coverage decisions about areas of medicine in which they are not properly trained. In this case, Mr. Cunningham alleged, a radiation oncologist was needed to properly determine if the treatment was covered under the policy, but the evidence showed Aetna used doctors with no radiation oncology experience. Those doctors denied Mrs. Cunningham’s proton therapy by saying the cancer treatment was “experimental or investigational.”
- Overworked Staff
- Unqualified Medical Reviewers
- Employee Bonuses Based on Company Profit
Also, Mr. Cunningham alleged Aetna places such heavy workloads on its in-house doctors that they cannot spend sufficient time reviewing claims before denying them. The evidence at trial was that they spent too little time considering Mrs. Cunningham’s claim for life-saving treatment. Finally, the evidence showed Aetna pays its in-house doctors significant bonuses based in part on the profitability of Aetna.
Ron and Orrana Cunningham's Case
I am happy to announce we obtained a $25.6 million verdict for our clients Ron and Orrana Cunningham in Judge Lisa Davis’ court in Oklahoma County. Our client is Ron Cunningham, a retired OKC firefighter. He is the toughest, most tenacious client you could ever ask for. He has been battling for justice in this case for 3 ½ years. Ron’s wife Orrana (a really amazing person) was diagnosed with stage IV nasopharyngeal cancer in November, 2014 when she was only 53 years old. This is Orrana.
This diagnosis came a couple of months after Ron and Orrana had finished building a house (almost entirely with their own two hands) on a farm near Meeker in eastern Oklahoma County. It was Orrana’s dream house.
Safeguarding the Future
The jury’s verdict sends a loud message to the health insurance industry. That message is that the public will not stand for a health insurance company wrongfully denying coverage for its policyholders’ covered medical treatment. The public will not tolerate an insurance company recklessly disregarding its duty of good faith and fair dealing owed to policyholders. We hope the jury’s message will reach far beyond the courtroom in Oklahoma City, all the way to the boardrooms and corner offices at Aetna, as well as other health insurance companies nationwide.
Mr. Cunningham is hopeful the jury verdict in his case will cause things to change in the health insurance industry. He did not want what his wife went through with Aetna’s repeated cancer treatment denials to happen to anyone else.
That’s why he has fought so hard to bring this case to public light.
PUTTING INSURERS ON NOTICE
A major victory in a larger fight against bad faith insurers.
Ron and Orrana Cunningham’s harrowing experience is both a cautionary tale of what is wrong with our current insurance system and a reminder that people won’t tolerate bad faith actors like Aetna. The jury sent a clear message to insurance companies by awarding the Cunningham family $25.6 million, including $10 million in punitive damages. Verdicts like this let insurers know that wrongfully denying people important treatments like proton beam therapy for cancer is unacceptable. Hopefully, insurance companies will realize they can be held accountable in court and have their practices scrutinized by the public if they fail to live up to their promises.
In another widely publicized case, Aetna’s medical director made the decision to deny a policyholder’s coverage even though he testified he had not reviewed the medical records before making the decision. The policyholder sued Aetna for insurance bad faith, and after Aetna had said they defend their policies when they are questioned the company later made the decision to settle the case before it went to trial. Aetna offered no reasoning about why it had done so. When asked about the case, Doug told CNN that “in my experience with Aetna, they don’t settle cases easily.” Read the full CNN story about this additional interesting Aetna bad faith case.
The fight will continue until the system is fair for every policyholder. We’re proud to be leading the charge against insurance companies that act in bad faith.
Attorney Doug Terry
Bad Faith Insurance Lawyer
Mr. Terry’s insurance bad faith experience runs deep. His clients include people and companies who have had their insurance claims denied, delayed or otherwise mishandled by insurance companies.
The significant insurance bad faith cases Mr. Terry handles arise from many kinds of insurance policies. These have included health, major medical, automobile, homeowners, disability, life and commercial insurance claims on behalf of clients who have been treated unjustly by insurance companies.
Mr. Terry has a proven track record of successfully litigating, settling and trying lawsuits for his clients. He takes pride in his reputation as a professional, aggressive, effective advocate for his clients. Mr. Terry takes great satisfaction from taking on tough cases and winning for his clients, but even more satisfaction from the positive relationships he builds with them.
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