Jury awards patient's family $25.5M in Aetna coverage denial case

A patient's family sued Aetna after the insurer denied coverage for proton beam therapy, according to News OK.

A jury awarded the family $25.5 million after hearing that the reviewing physicians spent a short amount of time examining the case before denying coverage.

The patient's family paid for the treatment, which reached $92,082, after coverage was denied. The patient died in 2015.

During the trial, the jury was presented evidence that two reviewing physicians "spent only minutes" reviewing the case, although the patient had a unique situation due the tumor's location. The physicians still denied coverage.

During the trial, it was revealed that one of the physicians reviewed more than 80 cases per day. According to the report, jurors felt the Aetna reviewing physicians were "rubber stamps" for the company.

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