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HMO of Louisiana, Inc.

Christiane Gullung Hymel recently obtained a health insurance policy from Blue Cross. She attempted to pre-certify a diagnostic MRI to determine if she had a tumor in her spine. Blue Cross denied the 33 year old homemaker's request, asserting that there was no coverage for the diagnostic MRI because they believed the request to be associated with a pre-existing condition. By not investigating the possibility of a tumor, the insurance company was in violation of Louisiana Insurance Code 22:657(D). Hymel was confined to a wheelchair, had surgery for the tumor, was treated at a public hospital for one month, and performed 18 months of rehabilitation. The 4 month delay in her diagnosis and treatment allowed a previously undiagnosed tumor to continue to grow and required a second surgery to remove residual portions of the original tumor. Hymel is permanently and totally disabled and will be on medication for the rest of her life to control the neurological Astatic. The jury awarded $2,000,000 for loss of enjoyment of life; $50,000 for physical injuries; $70,000 for unpaid past due medical bills; $70,000 penalty based on those medical bills and the wrongful failure to pay them; $15,000 in future medical expenses; and $101,000 in attorney fees. (Feb-14-05) [LAWYER EMAIL] [LAWYER WEBSITE]


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Published on May-19-05


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