KTLA VIDEO: Patient Sues Blue Cross For Denying Liver Transplant
Source: KTLA.com
Article Note: This article appeared February 23, 2010 on the KTLA website as Domine | Adams attorney Jason Adams begins jury trial against California's largest for-profit insurance company Anthem Blue Cross and its parent, Wellpoint, Inc. for a wrongful denial of a liver transplant.
LOS ANGELES -- The nation's largest health insurer, WellPoint, Inc., and its California subsidiary, Anthem Blue Cross, are being sued by a man who says he was denied a life saving liver transplant based on geography.
The lawsuit was filed by 61-year-old Ephram Nehme, a Lebanese immigrant, who claims he was automatically denied coverage for a liver transplant that his doctor said was medically necessary to save his life.
As a result of the insurer's decision, Nehme paid over $205,000 with his own money.
Blue Cross lawyers have denied wrongdoing on the part of the company and say Nehme went outside of the coverage network to have his surgery in Indiana after the transplant was already approved at UCLA, leaving no obligation for any reimbursement for out-of-state care.
However, Nehme's lawyer Scott Glovsky argues that Blue Cross should pay the full cost of the transplant because the wait in California would have been fatal.
According to Glovsky, Nehme had a rapid progression of his liver disease in 2006 that originated with a tainted blood transfusion.
His nurses and doctors, including UCLA hepatologist Dr. Sammy Saab, recommended that he travel to Indiana University because they doubted he could get a transplant within a reasonable time at the Westwood medical center, Glovsky said.
Read the full text of the KTLA News story.
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