Lawsuit Filed Against Blue Cross

Posted June 15, 2016

Although researchers have made great strides towards curing cancer in recent decades, there are still strains of the disease that are notoriously difficult to eradicate. Unfortunately, it can take a significant amount of time for particular procedures to be approved by the medical community. This problem is compounded by the increasing power of insurers to dictate patients’ access to newly developed treatments. Recently, an Oklahoma resident suffering from prostate cancer filed a claim of bad faith against his insurance company for ceasing to cover proton therapy treatment.

Proton Therapy Coverage

Last year, prostate cancer patient Randy Farland sought treatment at Oklahoma ProCure Management, a proton therapy center located in Oklahoma City. Proton therapy is a form of radiation that allows increased targeting of cancer tissue. As a result, there is a much lower risk of damage to surrounding soft tissue. Though it has been in use since the 1970s and is FDA approved, some insurers still consider the treatment experimental and so refuse to cover it.

This is in large part due to the fact that some physicians have questioned whether proton therapy is actually more effective than other methods of treating cancer. Adding to this concern is the claim that proton therapy is significantly more expensive than other forms of radiation. The Journal of the National Cancer Institute supported this assertion by reporting that the median Medicare reimbursement for proton therapy is twice that of more traditional treatments, such as intensity-modulated radiation therapy (IMRT).

Proponents of the therapy counter by arguing that though the treatment may be more expensive in the short-term because patients will experience far less debilitating side effects, some of which may require further treatment, they will actually save money in the long run.

Bad Faith

Though Farland’s insurance provider initially covered treatment, it ceased to do so in 2015 without explanation.  Farland was subsequently denied coverage on four separate occasions. In response, Farland filed a claim against Blue Cross and Blue Shield (BCBS) of Oklahoma for violating its fiduciary duty to act in good faith.

Get Help Now

An insurance company’s failure to provide coverage may constitute bad faith and can have devastating repercussions on a policyholder’s health and emotional well-being. If you were denied coverage and have reason to believe that it was done in bad faith, it is important to contact an experienced attorney who can help you obtain the compensation you deserve. Please contact a member of our legal team at the Bennett Law Firm at 405-272-0303 to schedule a consultation with one of our bad faith insurance attorneys.