Glendale, CA: Under the current healthcare system, patients often have no protection against their health insurers' treatment decisions. Recent events, however, have compelled the California Insurance Commissioner to put pressure on the Life Insurance Company of North America (LINA insurance), which also operates under the CIGNA Life Insurance Company of North America brand, to reform some of its unsavory activities in the processing of claims.
The story of Nataline Sarkisyan, a 17-year-old who died on December 20, 2007 after waiting for a life-saving liver transplant, is well known. However, a recent report by Leslie Miller of KABC Los Angeles has stirred up some still-raw emotions. The report first aired on ABC's Good Morning America and is now making the rounds on YouTube.
Miller stated that CIGNA, the Sarkisyan's insurer, initially agreed to the surgery. However, after Sarkisyan received a bone marrow transplant from her older brother that left her with a serious lung infection, CIGNA delayed, and then denied, approval. The insurance company claimed that the surgery was too experimental, even though doctors supported the surgery and a donor liver had been secured.
With their daughter in grave condition, Greg and Hilda Sarkisyan filed an appeal. Doctors at UCLA Medical Center signed a letter urging CIGNA to review its decision. Time was short. "Every minute that they delay, every second, every last second counts," stated a supporter of the family.
A rally formed outside the CIGNA headquarters in Glendale, California. "CIGNA cannot decide who is going to live, and who is going to die," declared a woman who identified herself as a concerned mother. Geri Jenkins of the California Nurses' Association was equally outspoken in her support of the Sarkisyans. "They have insurance. And there's no reason that the doctor's judgment should be overridden by a bean-counter sitting in an insurance office."
Within minutes, while the rally was still going on, a supporter in full view of the television cameras whispered to Hilda Sarkisyan that approval had been secured for surgery.
A cheer went up from the crowd.
But then the family got another call. "She's not doing good," Greg Sarkisyan said. "We're going to the hospital right now."
Hours later, wearing the same shirt and jacket he had worn at the rally outside CIGNA headquarters, Nataline's father faced the television cameras again. "My daughter….she's in God's hands right now."
The Sarkisyans' wrongful death suit against CIGNA was blocked, but the family has been allowed to sue for mental anguish after Hilda Sarkisyan was heckled during a visit to the CIGNA headquarters in Philadelphia.
Meanwhile, the story hit the news circuits. The host of Good Morning America commented, "In many instances the [insurance] companies decide what care you get—not the doctor."
In an unrelated investigation, the California Insurance Commissioner found that between February 2005 and June 2006, LINA / CIGNA made some long-term disability claims determinations prior to requesting medical documentation. The insurance company also frequently ignored new medical information on a claim.
According to CIGNA, the company had nothing to gain by denying Sarkisyan's request for a liver transplant, since it was merely administering the insurance plan of Greg Sarkisyan's employer and would not bear the cost of the surgery. However, by eventually approving the transplant, CIGNA put itself directly on the hook for the cost.
If you have suffered losses in this case, please send your complaint to a lawyer who will review your possible [LINA insurance Lawsuit] at no cost or obligation.
READER COMMENTS
Posted by SelesteSabatino
on
CIGNA ALWAYS uses the employer contract as their scapegoat. It is ridiculous what they get away with. I DESPISE CIGNA yet it is what I had to deal with when I worked for Quest Diagnostics and I am pretty sure I got the raw end of the deal, but I just don't have the energy or time to fight it....
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The story of Nataline Sarkisyan, a 17-year-old who died on December 20, 2007 after waiting for a life-saving liver transplant, is well known. However, a recent report by Leslie Miller of KABC Los Angeles has stirred up some still-raw emotions. The report first aired on ABC's Good Morning America and is now making the rounds on YouTube.
