A recent story about how an insurance company refused to pay for a procedure that could have saved a young girl’s life is very sad. A 17-year old girl died just hours after her health insurance company reversed its decision not to pay for a liver transplant that her doctors said the girl needed. Nataline Sarkisyan, who died on December 20th at University of California, Los Angeles Medical Center, had been in a vegetative state for weeks. Her mother, Hilda Sarkisyan, believes “the insurance company is responsible” for her daughter’s death.

The teenager, who had been battling leukemia, received a bone marrow transplant from her brother. However, she developed a complication that caused her liver to fail. Doctors at UCLA determined she needed a transplant and sent a letter to CIGNA Healthcare on December 11th.

The Philadelphia-based health insurance company denied payment for the transplant and the girl died. It was reported that about 150 teenagers and nurses protested outside CIGNA’s office in Glendale, California. While the protesters were rallying, the company reversed its decision and said it would approve the transplant.

Despite the reversal, CIGNA said in an e-mail statement before Nataline died that there was a lack of medical evidence showing the procedure would work in her case. That surely doesn’t appear to have been the case, based on what the doctors at UCLA had to say.

Beasley Allen Law firm handled a similar case several years ago after a health insurance company refused to approve a procedure that was needed by our client’s teenage son. We proved in that case that the insurance company was delaying its approval without any medical justification. In fact, we learned that the company believed the young boy would die during the delay and they could avoid paying for the needed procedure.

 



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