FOXLA VIDEO: Blue Cross sued for Cost of Transplant
Source: myFOXla.com

Article Note: This video and article appeared February 22, 2010 on the myFOXla.com website as 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 - Blue Cross of California should pay the $205,000 cost of a liver transplant for a man who went to Indiana for surgery because the wait in California would have been fatal, a lawyer said in the opening statements on Monday in the suit against the insurer.

Scott Glovsky addressed a Los Angeles Superior Court jury on behalf of 62-year-old Ephram Nehme, who alleges breach of contract. Glovsky said Nehme had to pay for the transplant because he would have died without it.

"Ephram went out of state ... to save his life," Glovsky said.

Blue Cross attorney William von Behren told jurors there is no medical evidence Nehme would have died had he waited to have his surgery at UCLA. By going out of the Blue Cross coverage network, he left the insurer with no obligation to pay for his out-of-state care, von Behren said.

"No ... doctor told him to go elsewhere or die," von Behren said.

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 story at MyFOXla.com

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