Judge Allows Lawsuit Against Insurance Company for Emotional Distress

In 2007, a 17-year-old girl, was refused a liver transplant by her health insurance company. The transplant was denied because the health insurance company said that it was experimental and was not covered. After a storm of publicity, the health insurance company agreed to the transplant nine days later but it was too late and the 17-year-old girl died a few hours later. Ten months later, the deceased’ mother went to the insurance company’s headquarters and announced at the security desk in the lobby that “You guys killed my daughter. I want an apology.” Instead of an apology, she got heckeled by insurance employees looking down into the atrium lobby from a balcony above and one of them gave her the “finger.”

The child’s parents parents filed a wrongful-death lawsuit against the insurance company’s for their child’s death due to insurance company’s refusal to pay for the transplant. A Los Angeles judge threw out the complaint, saying that it was barred by a 1987 U.S. Supreme Court ruling that shields employer-paid healthcare plans from damages over their coverage decisions. Under the 1974 Employee Retirement Income Security Act, or ERISA, the only monetary damages that beneficiaries of workplace health plans can sue for is the cost of the treatment of service in dispute, not damages arising out of refusal of the treatment.

Recently, a U.S. District Court Judge ruled that the parents could pursue damages for any emotional distress caused by the incident at the insurance company’s headquarters. The parent’s of the child are hoping that by bringing the wrongful-death suit the legislature will see that ERISA needs to be revised and that insurance companies need to be liable for their treatment decisions.

If you or a loved one has been injured by delay in coverage by health insurance companies or have been injured by negligence of a third person call my Rockville or Baltimore offices for an initial case review and consultation at 1-800-320-0080.