LA TIMES: Anthem Blue Cross should reimburse California man for transplant, jury says
Source: Los Angeles Times
PHOTO CAPTION: Liver transplant recipient Ephram Nehme, center, with attorneys Scott Glovsky, left, and Jason Adams confer at a news conference to discuss the trial against Anthem Blue Cross. Nehme said he saw his lawsuit as a way to pressure Blue Cross to stop denying out-of-state transplants. (Allen J. Schaben / Los Angeles Times / February 22, 2010)
By Lisa Girion | March 16 2010
A Los Angeles jury concluded Monday that Anthem Blue Cross should cover the cost of an out-of-state liver transplant that a California man paid for after the insurer balked.
In addition, the jury ordered Blue Cross to pay plaintiff Ephram Nehme's legal expenses, which could dwarf the $206,000 cost of the transplant.
Blue Cross approved Nehme's liver transplant in late 2006, and he was on the waiting list at UCLA Medical Center. But the company refused to pay when Nehme, gravely ill and fearing for his life, decided to have the operation in Indiana, where wait times are far shorter than in California.
The jury, which included at least three members with Blue Cross medical coverage, voted 10 to 2 that the company breached its contract with Nehme. It voted 9 to 3 that the health insurer acted in bad faith by refusing to pay for the out-of-state operation. The panel deliberated for less than two days.
Read the full text of the LA Times story.
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