CIGNA Employee Flips Off Mother Of Dead Girl Denied Transplant

A CIGNA employee gave the finger -- literally -- to a woman whose daughter died after the insurance giant refused to cover her liver transplant.

Hilda and Krikor Sarkisyan went to CIGNA's Philadelphia headquarters, along with supporters from the California Nurses Association, to confront the CEO Edward Hanway over the death of her 17-year-old child.

In 2007, Nataline Sarkisyan was denied a liver transplant by the company, on the grounds that the operation was "too experimental" to be covered. Nine days later it changed its mind, in response to protests outside its office. It was too late: Nataline died hours later.

"CIGNA killed my daughter," Nataline's mother Hilda told security. "I want an apology." Sarkisyan was not able to speak to Hanway; a communications specialist talked to her instead. After their conversation, employees heckled the group from a balcony; one man gave them the finger. CIGNA called the police and had the family and their friends escorted from the building.

A CIGNA executive apologized for the incident in a letter about a month later.

"I was very disappointed to learn of the behavior of one of our employees when you were at our company's headquarters," wrote John M. Murabito, executive vice president for human resources.

"I sincerely regret this individual's offensive and inappropriate action," he continued. "Please know that he did not represent the views of our company or the views of other employees who work here. We deeply empathize with you and wish you peace and comfort in your loss."

"What unbelievable nerve," said Americans United For Change spokesman Jeremy Funk in a statement. "A case that should have prompted CIGNA to seriously reevaluate its policies instead led its employees to taunt and insult a grieving mother who lost her daughter. Absolutely sick. Does Congress need any more reasons to pass meaningful health insurance reform now?"

The Sarkisyan family's wrongful-death suit was thrown out of court because of a 1987 Supreme Court ruling that shields employer-paid health care plans from damages over their coverage decisions.

The Sarkisyans say the law needs to be changed to allow people to sue health insurers for these kinds of decisions.

"If you don't sue, you can't make changes," Hilda Sarkisyan said. "It's not about the money. It's about the principle. They are just going to keep denying people care if we don't stop them."

AUFC recently highlighted Nataline Sarkisyan's story in a television ad:

 

Comments

[robertogt]

03:47 PM on 10/12/2009

We've been collectively flipped off by our executive, legislative and judicial branches. That's assuming ther is still separation between them. And they wonder where the "civil unrest" iwill come from?

[JWB2012]

02:08 PM on 10/12/2009

Are the masses so bloody brainwashed that they don't "get" the advantages of the single payer idea?

[LuKennedy]

11:39 AM on 10/13/2009

In order for single-payer to work here, we would have to double our infrastructure and require more doctors to be general practitioners, which means healthcare will only get more expensive instead of less expensive. Our present system would work a bit better if there were more general practitioners, because there would be more competition between doctors and prices for ordinary office visits would remain stable. Look at places where single-payer system is in place--doctors are constantly vying for higher pay and they have trouble keeping their doctors in country because they like to come here where salaries are more satisfying. We have a much larger population, spread over a greater area than in most examples of single-payer systems, so naturally it will be more costly. Even if the government (taxpayer) were to pay for healthcare for all, we would still require cost control (which we need either way). Let's face it--most doctors practice medicine because they like the number of digits behind the dollar sign, not because they have any real interest in healing anyone. At the point at which you limit what is behind the dollar sign, you will see a decrease in doctors and an increase in lawyers. As religion has altogether failed us, unless you can find some miraculous way of regulating the morals of society in order to insure that people become prone to do the right thing, we're screwed no matter what system we have.

[JWB2012]

01:49 PM on 10/13/2009

You are correct. However,and of course this won't happen, but Just 8 days of the global military budget would feed the worlds hungry for a year. I can only imagine what a sane system could come up with. Universal health care is not something that should be debated - it should be automatic. But I'm just a dreamer. Imagine.

[robbyJ]

06:28 PM on 11/10/2009

1984

The republican party is inert, and greed is eating away at our future.

[BillLaimbeer]

11:25 AM on 10/12/2009

"Please know that he did not represent the views of our company or the views of other employees who work here. We deeply empathize with you and wish you peace and comfort in your loss."

The police escort must have been a show of respect.

[Concerned Citizen]

11:25 AM on 10/12/2009

It is amazing that huge corporations continue to receive enormous subsidies, tax breaks, "oil depleton allowances", and other forms of corporate welfare while the individual is left to fend for himself. Socialism for the wealthy, at the expense of the general population, has been going on for over a hundred years. What on earth do people think the "military industrial complex" is all about but funnelling our tax dollars into the coffers of huge defense-related corporations?! The insurance industry plays a particularly egregious role in that the claims paid out are written off as a loss. How nice! They just want to collect premiums. Whenever they actually pay out a legitimate claim (their ostensble raison d'etre) they get to write it off. Quite a lucrative scam! What is the actual value of the "service" performed by an insurance company in the realm of healthcare? It plays the role of a middle man, a "broker", between the individual and the doctor/hospital. The insurance "profits" are the "tribute" we pay for "services rendered".

[dbltrouble]

11:18 AM on 10/12/2009

4) Even if the employee who flipped the bird was not acting in an official capacity, it is indicative of the culture of the company.

5) Unfortunately, the family took the tact of the protesters at many of the town hall meetings of being confrontational and not allowing the "spokesman" to try to speak. Thus, it becomes venting rather than a dialogue and unlikely to elicit the answers to your questions.

[dbltrouble]

11:18 AM on 10/12/2009

3) Denials. Or Extent of Coverage.
How many actually read their health insurance contract and know what is and is not covered? This is the point of the reform bills with minimal coverage. Too often people try to minimize their costs and so they might choose the less expensive option, but not aware of what is and isnt covered - or the extent to which "medical care" can be parsed. Until recently, many policies did not include "mental health" coverage. (It's a good thing that many primary care physicians now feel comfortable treating at least mild depression to some extent now.) Even the AMA now admits, grudigngly, that the mind and body are connected and that both need to be cared for. Or, consider physical therapy. Many only think they need that if they have a stroke. But, you likely need it after a sprain, or other muscle/bone/tendon problem. And even after that heart attack.

You also hear of people who find that that one thing they needed, the surgery, etc, is not covered. This may be previously spell out, or a rude awakening at the time of precertification. In Switzerland, their "basic coverage" mandated by their legislature is equivalent to what many would consider a comprehensive plan in the US. Yet, with the difference in arrangement, Switzerland's medical care only encompasses about 10% of their GDP versus the 16% of the US GDP.

[dbltrouble]

11:18 AM on 10/12/2009

Thus, the potential coverage of the agent(s) or treatment plan by the insurer is ever more important. Again. This is the legacy of the misbegotten attempt at bone marrow transplants (BMT) to increase survival for breast cancer patients. This was considered unproven but had a great rationale. Many (most) insurers refused to cover BMT until there was such a hue. Again, this helped to undermine HMOs and cost controls. Patients began demanding this option whether or not the oncologists really thought this was the best option. They sought care at those institutions that would offer them this option. ... In the end, BMT does not improve survival, and likely decreases it because of the severity and risks of the BMT itself. (It's tough to survive without an immune system - something you have to do at least 2x in the process. As Randy Newman in Monk: It's a jungle out there.) Another well established yet experimental treatment that was later debunked includes the lobotomy - for which it's developer even received a Nobel Prize.

On the other hand, the excellent results we have for Hepatitis B and Hepatitis C that has decreased the risk for transplantation and more importantly, for cancer, are the result of experimental treatments and trials. The major difference is that these were for specific pharmaceutical agents and so those companies with a vested interest pretty much bankrolled those trials.

[dbltrouble]

11:17 AM on 10/12/2009

2) Standard of Care and what is actually covered. Early in the great technological blossoming of medicine - the 1960s through much of the1980s - insurers didn't touch "experimental" care. As almost all cancer therapy was still unproven, almost all care that was received was covered under a clinical trial - and likely the National institutes of Health or other foundations who bankrolled these trials.

This is not longer the case. Once an agent/drug is approved by the FDA, it is now left to the discretion of various physicians (usually hematologists and oncologists) to decide on a course of treatment based upon their understanding of the data available (or known to them). The most important difference is that no longer is there a REGISTRY of the situation and therapy to be included in overall analysis to clearly judge what therapies are superior for what situation.

[dbltrouble]

11:16 AM on 10/12/2009

1b) The real concern is when does DENIAL become a form of medical practice. Rather, any legal action will need to be based upon CONTRACT law. The fundamental question: DO INSURERS HAVE A FIDUCIARY RESPONSIBILITY TO THEIR SUBSCRIBERS?

Recall that it was partly the massive protests and walking away from HMO contracts as the "Case Managers" denied procedures and payment for Emergency Department evaluations as not emergent that has lead to their loss of market share, and laws that amiorlated at this some of these denials (the basis of same).

[dbltrouble]

11:15 AM on 10/12/2009

1a) This 'ability to pay" is even more evident for those without insurance. When they do finally seek care, it is usually at an Emergency Department with markedly higher costs and charges than an office visit. Too, data clearly demonstrated that they are more likely to end up in the Intensive Care Unit (20% more likely) - an indicator of the severity of the process at time of presentation. And, as you know, an entry into the ICU means there is a much higher probability that you will not survive. Consider the difference if a person is diagnosed with heart disease BEFORE the heart attack and receives appropriate care versus the one who waits "for the big one" (which may indeed be a "widow maker") and needs instead, the ICU, the cath lab and stents or reperfusion therapy and/or bypass. Heart attacks still have a major risk of death - it is the most common cause of sudden death. There is now significant damage to the heart and risk or actual heart failure.

THIS IS WHY ACCESS TO CARE MEANS LOWER COSTS and savings in the long run. This is why expanding to universal access and reducing those barriers to care will pay for getting those people access. This doesnt even talk about "indirect costs" or the lost wages, etc.

[dbltrouble]

11:14 AM on 10/12/2009

This case illustrates several points:
1) Payment or Ability to Pay = Medical Care.
Even the neocons admit, There is No Such Thing as A Free Lunch. This is especially true when it comes to medical care. Someone, somewhere has to pay the bill. A century ago, it was charitable institutions (many religious based as are many hospitals - another comment later) often with the scions of industry on the board who would summarily make up the budget deficit. This is not occurring any more. (The moguls not seem to only be on museum boards and the like if at all. Only Buffett and Gates through the Gates Foundation and Howard Hughes through his foundation seem to be involved in medical care today.)

Yet, that famous Supreme Court ruling used ERISA to put insurers, the payers, 1 step out of the circle regarding medical care decisions. This is the crucial point. As the insurers do not in themselves RECOMMEND tests, procedures, diagnoses, they have been determined to NOT be "practicing medicine" and thus, medical malpractice suits cannot be filed against them. instead, the paradigm is that you are making an investment in your (or your family member's) health/life and hence future happiness and earning power. It is YOUR decision whether or not the make that INVESTMENT, based upon the RISK for return.

[Wake-up]

10:42 AM on 10/12/2009

This is sad for sure...

But...

It's not like anything even close to this would EVER happen if Gov. was running healthcare... anyone who needs a liver would get it... the next day too.

Again, this is sad and I'm sure CIGNA is fixing its processes...

[LuKennedy]

09:40 AM on 10/12/2009

I'm disgusted. Insurance is meant to be a safety net in the case of catastrophe, but instead it is used by most to cover everyday things. We double mortgage our houses in order to pay for remodeling our kitchens, but when it comes to the health of our children, we'd rather protest in order to get someone esle to pay and then attempt to sue when our children die because we were protesting instead of solving the problem. The Emploeyrs that provide insurance determine the value of the health of their employees and their families, yet the insurance companies are blamed for the choices of those employers, when they are just the hired bad guys. Instead of going forward with the necessary lifesaving treatments and worrying about who will pay later, doctors and hospitals demand payment up front.

I'm disgusted with every person who had anything to do with the case of this poor girl, from her parents, to the insurance company, to the people who protested instead of raising funds, to the doctors, to the hospitals, to the lawyers who saw an opportunity to try and put a pricetag on the girl's head, to Rachel Weiner for writing this article in the way she did, trying to make anyone right when everyone involved was wrong. My god, what more evidence do we need in order to see that we live in a fundamentally ill society? We are crippled by our greed. It's grotesque!

[BillLaimbeer]

11:40 AM on 10/12/2009

A little sympathy for the devil? Seriously, you think the employers are responsible when an insurance company takes the literal action of removing someone from it's rolls?
Maybe you double mortgate your house to pay for a kitchen, but let's talk about the people not making enough to go beyond renting an apartment. These are the people I interact with daily who do not have health insurance, and it's precisely because their employers don't deem them worthy of living in the event of an illness to afford them insurance. It's much easier for the employer to hire someone part-time and deny benefits than it is to shell out for health care. Which is why it should not be left to the private sector to alleviate the public's health care problems. Having a health citizenry is beneficial to everyone in the citizenry (except private insurance companies) because it prevents the spread of disease and prompts diagnosis and treatment of illnesses earlier.
By bringing additional attention to the continual injustice and abdication of responsibility by the hands of insurance corporations, this family is attempting to solve the problem. Your comment is what's disgusting here.

[LuKennedy]

10:46 AM on 10/13/2009

Obviously you didn't read what I wrote before you decided to react to it. Try re-reading it. Then try re-reading what you wrote. See that we're saying the exact same thing. Then apologize for being foolish.

[ejr1953]

08:44 AM on 10/12/2009

I volunteered on the transplant unit of a hospital in NYC in the 2001-2004 time frame and liver transplants were NOT experimental at that time. If the patient's insurance specifically did not cover liver transplants, I'd say "the devil is in the details", that it's probably a case of "under insurance", if not, the willfull act denying treatment covered by the policy seems to me to be a form of homicide. We focus on the insurance company, but there are people who are making these decisions who need to also be held accountable for their behavior.

[longfeltwant]

07:51 AM on 10/12/2009

I read the article, and I see where a guy flipped off the protester, but I didn't see anything supporting the assertion that anybody "literally gave the finter" to anybody else. A health care worker could, I suppose, "literally" give a person the finger, but that would involve a disembodied digit, which isn't mentioned anywhere in the article. Thus, either the author of this article is making unsubstantiated claims, or completely misunderstands the meaning of "literally". Maybe what the author meant is "not literally".