Proton Therapy Treatment Approved After Insurer Initially Denied Claim

There is a tension in the American health care system between innovative medical procedures designed to save or prolong patients’ lives against the financial costs of that treatment. This tension has long simmered in proton therapy treatment of cancer. Standard radiation therapy has improved over the years and effectively controls many cancers. However, X-ray beams […]

Health Insurance Claim Denials: Aetna Doesn’t Review Medical Records

Recently, in a California insurance lawsuit involving the wrongful denial of health insurance benefits to a 19-year old claimant suffering from a rare immune-system disorder, a former medical director at Aetna (the defendant health insurer) admitted under oath to having never reviewed patient medical records when determining whether to deny health insurance claims. The testimony […]