When the Cigna spokesperson appeared to explain why they failed to live up to the terms of their insurance policy, it was not a doctor, or even the nurse it was the company treasure. Now what does that tell you about how they look on human life.
2007-12-25 17:23:47 · 4 answers · asked by sSuper critic 2 in Politics & Government ➔ Law & Ethics
A doctor should explain a MEDICAL decision, an officer of the company should explain a CONTRACTUAL decision.
The decision to deny coverage for the liver transplant was a legal decision, not a medical one, and the decision to offer to pay for it (too late) was a public relations decision, not a medical one, so it would not have been appropriate to have it explained by a Dr, since a Doctor is not supposed to allow financial considerations to affect his decision making.
The parents are unlikely to win a lawsuit, either, although Cigna may decide to offer a settlement - again, for PR reasons.
There are a lot of very good and experienced med-mal lawyers in California, but the lawyer they were able to get to represent them, Mark Geragos, is a criminal defense specialist, best known for unsuccessfully defending Mark Peterson.
Richard
2007-12-25 18:15:16 · answer #1 · answered by rickinnocal 7 · 1⤊ 0⤋
A doctor should explain a medical decision to the patient so that the patient can make the best decision possible. What you described is not a medical course of action. It was a public relations actions and, besides that, Cigna is an insurance company (looking for a profit) not a doctor (sworn to provide care for patients.
2007-12-25 17:34:39 · answer #2 · answered by StressedLawStudent 4 · 0⤊ 0⤋
Tells me that insurance sucks, but I already knew it did. It's a shame, but this is how this is going to shake out....
They will be sued, for 50 million+, they will fight this law suit for years at a cost of millionS. They will lose. They will appeal at a cost of millionS, they will lose again. They will pay the family 50+ million for their mistake.
Now, the most interesting twist. They will attempt to further decrease their reimbursements for services provided to their members.
But, THAT'S NOT ALL!!! As a bonus, to help further off set this loss (caused by their own mistake mind you), they will raise the premiums on all participant in their plan.
Now, it may take 10 years to replenish the hit they've taken to their cash reserve from this blatant error, but they will get every cent back plus some from each of US.
Conclusion, the only one that pays for an error ANYWHERE along the continuum of health care delivery are those that have insurance, and the federal government. By the way, to pay that share, the federal government taxes us, in the form of medicare tax, from those of us who work and have the money to buy private insurance.
Bottomline, Cigna didn't get screwed today, we did!! Congratulations middle class you just poked again! Just say no to socialized medicine!!
2007-12-25 17:36:13 · answer #3 · answered by abiogeek2 4 · 0⤊ 0⤋
You are right.
2007-12-25 23:47:48 · answer #4 · answered by WC 7 · 0⤊ 0⤋