Welcome to 2008, hopefully your family had a better end to the year 2007 than the family of Natiline Sarkisyan. Their year ended with a funeral for their teen-aged daughter who died after her health and medical insurance company refused to pay for a liver transplant and then reconsidered.
The Philadelphia-based Cigna HealthCare insurer has a history of approving coverage for over 90% of all transplants claims requested by their insured members, with over 90% of the liver transplant request being approved according to Cigna company President David Cordani in a memo addressed to employees and distributed to the media.
Cordani said the Sarkisyan’s claim was reviewed and evaluated using “evidence-based guidelines published by independent physician and medical organizations, as well as expert scientific journals.”
The 17-year-old leukemia patient, Nataline was in the intensive care at UCLA Medical Center for nearly three weeks after with complications following the insured and covered bone marrow transplant she received on November. 21, 2007.
Doctors at UCLA placed Sarkinsyan on the list for a liver transplant December 6, 2007 with a liver becoming available only four days later, according to family members. UCLA informed Cigna by $letter that patients in similar situations had a 65% chance of living six months after receiving a liver transplant.
The family’s benefit plan, provided through Natalines mother’s employer like most health plans does not cover experimental treatments. Cigna deemed the transplant as experimental in Nataline’s case and refused to pay for it.
Public outrage and a campaign supported by the California Nurses Assn., the Armenian community and the Daily Kos blog on the Internet resulted in telephone calls and e-mails to Cigna urging the insurance company to reconsider this decision.
Eventually Cigna authorized the transplant even though it was still considered experimental and outside the scope of the insurance coverage lacking medical evidence regarding the effectiveness of such treatment.
Cigna’s decision was too late and was made on same the day Nataline died. Following the denial of benefits her family decided t$o take her off life support. The family blames Cigna’s delay of approval for her death and have said they would file a lawsuit.
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