Companies are punished with monetary damages, but who’s out the dollars?
In November 2018, an Oklahoma jury returned a $25.5 million verdict against Aetna for improperly denying coverage for proton beam therapy, a treatment the company considered experimental. Evidence adduced at trial showed that no one in the oncology community considered that treatment experimental for the treatment of cancer and that the treatment, in fact, would have been covered by Medicare, had the plaintiff been aged 65 or over. It might even have been covered by Aetna if the plaintiff had been younger than 21, but she was not in this case.
In the largest verdict for bad faith in U.S. history, the jury found that Aetna “recklessly disregarded its duty to deal fairly and act in good faith” and awarded punitive damages. During the course of deliberations, the jury specifically discussed “sending a message” to Aetna and “making a statement” so Aetna would reevaluate how it handles appeals and requests for coverage.
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