Cut-Off Cancer Patient to Get $9M

LOS ANGELES — A woman who had her medical coverage canceled as she was undergoing treatment for breast cancer has been awarded more than $9 million in a case against one of California's largest health insurers.

Patsy Bates, 52, a hairdresser from Lakewood, had been left with more than $129,000 in unpaid medical bills when Health Net Inc. canceled her policy in 2004.

On Friday, arbitration judge Sam Cianchetti ordered Health Net to repay that amount while providing $8.4 million in punitive damages and $750,000 for emotional distress.

"It's hard to imagine a situation more trying than the one Bates has had to endure," Cianchetti wrote in the decision. "The rug was pulled out from underneath, and that occurred at a time when she is diagnosed with breast cancer, one of the leading causes of death for women."

Bates, a mother of two, said she screamed when she heard about the damage award.

"I am elated," she said.

Bates' attorney William Shernoff said he wanted other insurers to take notice of the award.

"We are going to put a stop to this practice," he said.

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Health Net said it was implementing a freeze on policy cancelations that would last until the company sets up a third-party review panel to scrutinize cases.

"Obviously we regret the way that this has turned out, but we are intent on fixing the processes to maintain the public trust," spokesman David Olson said.

The award came a day after the Los Angeles city attorney sued Health Net, claiming it illegally canceled the coverage of about 1,600 patients. City Attorney Rocky Delgadillo also said the company illegally ran an incentive program in which it paid bonuses to an administrator for meeting targets of policy cancelations.

Health Net acknowledged that such a program existed in 2002 and 2003 but was subsequently scrapped.

"It's hard to imagine a policy more reprehensible than tying bonuses to encourage the recision of health insurance that helps keep the public well and alive," Cianchetti wrote in the Bates decision.

Bates had been insured with another company but was persuaded to switch over to a Health Net policy after an agent suggested she could save money.

She said she had undergone surgery to remove a tumor and had received her first two chemotherapy treatments when doctors stopped treating her because her bills were going unpaid.

"I was devastated. I didn't know what was going to happen," Bates said. "It's boggling that someone can do that to you."

Bates went on to complete her cancer treatment through a state-funded program.

Health Net also said it would review its practices and the way its brokers and agents are trained.

Comments

[javaman]

the healthcare industry now is a 4 trillion dollar money maker. it accounts for 1 out of every 5 dollars spent in this nation.

with just that money alone we could provide national health care not just for the US but for the whole world.

If there ever was an argument as to why we will never ever get nation healthcare, I'll give you 4 trillion reasons.

Now that china-mart is now opening their own "healt clinics" (god help us all), this has basically taken national health care around the back of the house and put a bullet through it's head.

[FaaLaveLave]

With the Republicans no improvement in health insurance is not even mentioned and the two remaining Democrats are only slightly better. Both want to "work out" health plans with the insurance companies "at the table".
Looks like the only hope for improvement might be with John Edwards as Vice President in an Obama administration.
My husband was a teacher for forty years and is now retired. Our insurance premiums get higher each year. We are now forced to use Aetna PPO plan with higher co-pays each year and many of our claims are denied completely.
Unless things change we may well have only Medicare in a very few years.

[FightingTheRight]

This should be on the front page of every neswpaper in America.

Then maybe people would realize what private insurance companies are all about.

[MilwaukeeMike]

Yes it should. It won't be, but it should be. This stuff happens all of the time.

[joebaggadonuts]

I'll be cheering if the Supremes don't overturn this.

This is what the law is supposed to do, allow individuals to have power over their own lives. Here the Ins. Co. tried to destroy her to save themselves a few bucks. If we can't count on the law to save her in this situation, there's no reason to respect the law.

[Joeseo]

American Corporate Government is based on laws bribed into effect. Individual rights are treated as a joke and made worthless.

This fraud has continued since initiated by HMOs.
Managed care means only Managers making bonuses by reducing health care.

Only in 'merica! Lets see now if that Corporate bastard French President can perform as well.

[joebaggadonuts]

Be the change.

[emerywood]

Why is this not considered as criminal offence is beyong me. The healthcare company took the insured's premium and then denied coverage without reason. Isn't that fraud ? If this is not crime, then all types of insurance would be suspect. Who would still want to purchase insurance for anything ?

[FightingTheRight]

Depraved Indifference?

[reactionrynihilist]

Privatized health care isn't going to work unless there is a huge amount of transparency, and the industry isn't going to allow it. We are starting to lose our edge on new discoveries in medicines, and our health care system gets sorse for the average american every year. The HMO experiment is over and they failed. We need single payer or highly regulated private health. The proposals I see from candidates are merely handouts of public funds to private companies with no incentive to actually improve public health.

[reactionrynihilist]

Privatized health care isn't going to work unless there is a huge amount of transparency, and the industry isn't going to allow it. We are starting to lose our edge on new discoveries in medicines, and our health care system gets sorse for the average american every year. The HMO experiment is over and they failed. We need single payer or highly regulated private health. The proposals I see from candidates are merely handouts of public funds to private companies with no incentive to actually improve public health.