Insurance Liabilities Under Coverage Decisions

A lawsuit has been filed by a woman, by the name of Hilda Sarkisyan. The suit was filed against Cigna Corp. after she paid a visit to Cigna headquarters requesting an apology for the companies refusal to pay for a liver transplant for her teenage daughter a few months back, which resulted in her daughter’s death. Upon arriving, Ms. Sarkisyan was not greeted with an apology, but instead with ill- mannered treatment from Cigna employees. Prior to the current case, a lawsuit was filed against Cigna due the death of her 17 year old daughter and Cigna’s refusal to cover the costs for her liver transplant. The judge threw out the case stating that according to the 1987 U.S. Supreme Court ruling, employer – paid healthcare plans are protected from any damages or injuries over their coverage decisions. But according to Judge Gary Allen Feess (U.S. District), Ms. Sarkisyan has the option to pursue damages for her personal, emotional stress caused by the wrongful – death complaint. Many individuals agree in the fact that this raises awareness for the need of federal legislation to permit people to file a suit against health insurers for a life – or – death decision that they may be making. The company admits that at the time Ms. Sarkiyan’s daughter was in need of a liver transplant but the surgery was considered an experimental surgery and not covered under insurance. Finally, after receiving a large volume of publicity, Cigna agreed to cover the teenager’s liver transplant only to find out that the teenager died a couple hours later. Under the Employee Retirement Income Security Act, the only damage that can be collected through beneficiaries of workplace health plans is the price of the required treatment that is in dispute.

– Source: Los Angeles Times


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