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Jury Hands Down Verdict of $25.5 Million Against Aetna

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An Oklahoma widower was awarded $25.5 million by a jury against Aetna health insurance because his wife, a cancer patient, was denied coverage by Aetna. The jury found that Aetna acted recklessly.

In 2014 Aetna denied coverage for a woman who had nasopharyngeal cancer in her brain stem. Her doctors wanted to provide her with a proton beam therapy, which is a form of radiation that targets a specific tumor without the risk of debilitating side effects such as blindness or memory loss. Aetna denied coverage for the treatment stating that the therapy was "experimental."

The woman filed the lawsuit against Aetna; however, passed away during the pendency. Her husband decided to continue with the case in hopes of saving others. Aetna's attorney allegedly argued that Aetna was proud of the three medical directors that denied coverage and according to witnesses even turned to the medical directors to "thank" them during closing arguments. Aetna's defense focused on the argument that the proton beam therapy was "experimental." However, experts for the plaintiff testified that the proton therapy is well-established treatment for cancer and has been for decades. One expert was even quoted as saying "nobody in the oncology community considers proton therapy experimental for the treatment of cancer."

If you or someone you know has been mistreated by an insurance company, contact an attorney at Abraham, Watkins, Nichols, Sorrels, Agosto & Aziz by calling 713-222-7211 or toll free at 1‑800-870-9584.

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