For generations, people have had some form of insurance in order to mitigate their losses in various ventures. In modern society, an insurance company offers valuable protection from a variety of situations, including health problems, fire losses and car accidents. People from all walks of life in New York and elsewhere typically have a number of different policies in force at any given time.
Recently, one of the biggest names in health insurance, Blue Shield Life and Health found itself named in a class action suit filed by patients who had been denied coverage for an expensive medication. The patients all had been diagnosed with a serious liver disease and had sought treatment at medical centers. The physicians treating them had apparently prescribed a newer medication used to treat the chronic disease.
Initially, the insurance carrier refused coverage for that particular medication on the grounds that it was not proved to be medically indicated at that point in the patients' treatment. At that time, the damage their organs had suffered was not severe and there was another medication that could prove to be just as effective. The patients decided to file the class action lawsuit to force the company to provide coverage for the prescribed medication.
During the course of the lawsuit, the insurance company revised its policy for providing coverage for that particular drug. The judge then dismissed the case. Interestingly, two of the patients were treated with the less expensive medication and are considered free of Hepatitis C. The third patient received the drug at the center of the class action suit. New York insurance companies who find themselves embroiled in litigation have access to professionals who specialize in defending against claims that could otherwise prove to be detrimental to company finances and to their standing within the insurance industry.
Source: contagionlive.com, "Class-Action Lawsuit Filed Against Insurance Company Over Denied Harvoni Coverage Dropped", Khristi Rosa, Jan. 18, 2017