Proton Therapy Insurance Denial Attorney

A proton therapy insurance denial can spell disaster for patients battling cancer.

The law requires insurance companies to do right by their clients. When they fail to fairly investigate and timely make a decision, then deny a critical treatment for unfair or invalid reasons they are likely acting in bad faith.

Doug Terry knows how to deal with health insurance companies who deny cancer treatment, including proton beam therapy. If you have received a denial of coverage for proton beam therapy, you don’t have to accept that denial. Contact the health insurance denial attorney Doug Terry to learn how he can help. Call (405) 400-1066 or fill out our online contact form to schedule a free, no-obligation case evaluation.

How Proton Beam Therapy Works

Proton beam therapy is a type of radiation treatment used to treat cancer patients. It is often recommended by highly qualified radiation oncologists to treat difficult tumors.  Proton therapy has become more and more advanced and popular in recent years, as opposed to photon-based radiation, often called IMRT. Proton beam therapy is equally effective as IMRT at killing cancer cells, but there is often a huge advantage to using proton beam therapy.  It delivers radiation in a more precise, confined way than the less advanced forms of radiation treatment like IMRT.

The precise targeting of the radiation allowed by proton beam therapy is especially useful in patients where a tumor is next to vital but healthy organs or body parts, because it can target the cancer with far less damaging side effects than conventional radiation treatments.  Proton beam therapy can be used to radiate only the cancerous tumor while avoiding radiating (and potentially seriously harming) healthy parts of the body.

Proton beam therapy is a safer, and thus more effective cancer treatment than x-ray or photon-based treatments. One would hope that proton beam therapy would be used more often to treat cancers. Though proton beam therapy has been used for decades, its use is becoming more common. Health insurance companies all too often deny coverage for this important treatment.  Even worse, the insurance industry often utilizes unqualified, untrained, biased and overworked medical personnel to make these critical claim decisions.  Doug Terry believes this practice is just plain wrong, and will fight the companies who do it.

When Your Insurance Company Denies Proton Beam Therapy

If your doctor has recommended proton beam therapy to treat your cancer, you are likely in great need of this therapy’s benefits. Doctors don’t order proton beam therapy on a whim. They do it because a patient needs an effective method of killing or shrinking a tumor. In other words, this type of cancer therapy is recommended only when it is essential.

Sadly, insurers sometimes deny coverage of proton beam therapy. They might call the therapy “experimental or investigational,” or they might argue proton beam therapy is “not medically necessary.” Without insurance coverage for this much-needed treatment, patients may be forced to resort to taking out loans, selling cherished property or settling for a less effective, more harmful treatment.

It sounds unjust, because it is. Health insurance exists to cover costs of vital treatments. A proven treatment like proton beam therapy offers patients a chance at survival, with the least amount of side effects possible; and if an insurance company denies coverage, they may be acting in bad faith toward their policyholder.

An unwarranted proton beam therapy insurance denial is unacceptable.

When patients need treatment for a serious illness like cancer, insurance companies must live up to their promises. If you or a loved one has experienced a proton therapy insurance coverage denial, call Doug Terry at (405) 400-1066 or fill out our online contact form to schedule a free case evaluation with our team.

Doug Terry Knows Proton Beam Therapy Insurance Denials

In a high-profile case, Doug Terry represented Ron Cunningham, whose wife’s insurance company, Aetna, denied coverage for proton beam therapy to treat stage IV nasopharyngeal cancer. Ron and his wife, Orrana, were forced to borrow money against their dream house to cover the $92,082.19 cost of proton beam therapy.

After Orrana’s passing, Ron and Doug Terry continued the legal battle against Aetna for the denial. Doug’s investigation revealed a fundamentally broken and flawed system. Aetna had an overworked staff, unqualified medical reviewers and offered its in-house doctors bonuses  based on the company’s profits.

The jury heard the evidence at trial and agreed Mr. Cunningham’s case was important enough to render a substantial verdict.  The jury  decided on a $25,592,089.19 verdict. The jury awarded Ron $500,000, in addition to the $15,000,000 it awarded Mrs. Cunningham’s estate for their mental and emotional pain and suffering caused by Aetna’s bad faith conduct, and an additional $10,000,000 in punitive damages to send a message to Aetna by punishing them.  Members of the jury stated after the trial that they rendered the verdict because they thought the insurance company’s system was broken and they wanted the company to change it.

Ron’s story isn’t an isolated incident. Since the Aetna verdict, which is the largest verdict ever entered in the country involving proton beam therapy, the tide appears to be turning on the insurance industry.  Doug is now pursuing insurance bad faith cases around the country involving proton therapy denials.  Doug has heard from patients all across the country who have been denied proton therapy by their insurers.

A federal judge who was presiding over a proton therapy case in Miami, Florida recently recused himself from the case because of his own personal experience with a proton therapy denial by his insurance company.  The judge entered a recusal order containing a powerful statement:

It is undisputed among legitimate medical experts that proton radiation therapy is not experimental and causes much less collateral damage than traditional radiation. To deny a patient this treatment, if it is available, is immoral and barbaric.”

 

Call Doug Terry For a Free Consultation

If you want an attorney with specific experience handling proton beam therapy insurance denials, call Doug Terry at (405) 400-1066. Doug has a proven track record showing that he can hold insurance companies accountable for their bad faith denials.

Doug offers free consultations to give potential clients a better idea of what to expect from the legal process. During the case evaluation, Doug will review the details of your case and provide feedback that you can then use to decide whether to move forward with a claim against your insurance company.

Doug welcomes tough cases, and he never shies away from a fight with insurance companies. He wants to use his experience to continue the work he has done for clients who have been denied coverage by bad faith insurance companies.

Don’t accept your insurance company’s proton beam therapy denial. Contact Doug Terry today to talk to an advocate who knows how to get results.