Have You Been Injured? We're Ready to Fight for You.

$25.6 Million Awarded in Bad Faith Lawsuit Against Medical Insurer

Published on Jan 8, 2019 at 8:33 am in Insurance Bad Faith.

In November 2018, a jury in Oklahoma City, OK awarded the family of Oranna Cunningham nearly $25.6 million for a bad faith insurance lawsuit after she lost her battle with cancer.

Cunningham has been diagnosed with advanced nasopharyngeal cancer. Her physician recommended proton beam therapy; however, her insurer, Aetna, refused to cover the cost of the therapy because they deemed it to be experimental.

Proton beam therapy is recognized by the FDA and is often approved for pediatric and Medicare patients. The treatment allows doctors to focus cancer-fighting proton energy on the cancerous cells. Because it’s targeted, it preserves organ health and may reduce other harmful side effects.

Because of the location of Cunningham’s tumor, blindness and memory loss were risks. At the age of 54, however, she was deemed neither young or old. While unexplained, this age gap put her outside the range of insurance coverage. Because of the denial, the Cunningham’s had to mortgage their home to pay for the proton beam treatment. She died shortly after receiving the treatment and her husband filed a bad faith insurance lawsuit in an attempt to hold the insurance company responsible for their actions.

Mr. Cunningham’s attorney claimed Aetna’s denial involved underqualified doctors who were working in the best interests of the bottom line, instead of Ms. Cunningham. None of Aetna’s in-house medical reviewers were specialists in proton beam cancer therapy. One physician was an internal medicine doctor who had not practiced with patients in 25 years. Another reviewer was a general surgeon. The third was a hematologist/oncologist who had no experience with radiation therapy.

The reviewers were also found to have not spent more than 30 to 45 minutes reviewing claims for treatments and at least one had filed an official personnel complaint regarding having to review 80 plus claims per day. It was also clear that not a single reviewer had read the insurance contract prior to denying Cunningham’s claim. One of the reviewers had spoken to Cunningham’s doctor and acknowledged the treatment was recommended but said the claim had to be denied anyway.

The jury agreed the insurance company acted in bad faith and nearly $10 million of the total compensation was awarded in the form of punitive damages, as a way to punish the insurance company for their action.

Treatments deemed experimental or investigational by insurance companies cause problems for individuals who are seeking forms of modern medical treatment. This often includes technologies like pacemakers and microprocessor-augmented prosthetic knees. While there is some success when attempting to reverse the denial, it can take weeks – which not every patient has. Bad faith insurance claims can help victims and their families recover some of the losses they’ve incurred.


Free Case Evaluation

At Thomas Law Offices, our personal injury attorneys recognize that our potential clients are likely going through some of the most difficult times of their lives. We don't want you to have to worry about paying out of pocket for legal advice when you're just starting to learn your legal rights and options. That's why we provide free case evaluations. We'll offer our expert advice about your potential case and walk you through how we can help you.

Call us or fill out the form below to tell us about your potential case and a personal injury lawyer will get back to you as quickly as possible.

Meet Our Founder

Tad Thomas - Trial Lawyer

Tad Thomas

Managing Partner

Tad Thomas has dedicated his practice to representing plaintiffs in various types of civil litigation, including personal injury, business litigation, class actions, and multi-district litigation.

After graduating with his law degree in 2000 from Salmon P. Chase College of Law at Northern Kentucky University, Mr. Thomas immediately opened his own private practice and began representing injury victims.

In 2011, Thomas Law Offices was established in Louisville, Kentucky. Over the past decade, Mr. Thomas has expanded his firm and now has offices in three additional locations: Cincinnati, Ohio, Columbia, Missouri, and Chicago, Illinois. He is also a frequent lecturer on topics like trial skills and ethics and technology.

Legal & Firm News

When Prior Authorization Leads to Harm Caused by Delayed Care

In March 2023, the American Medical Association (AMA) released the results of a survey conducted on the impact of health insurance prior authorization (PA) on patient care and outcomes. The survey results revealed shocking information about the extent to which health insurance companies control the type of medical care patients receive. At Thomas Law Offices, […]

Read More

How Do I Sue a Hospital for Medical Negligence?

Medical errors and other types of health care professional negligence have soared in recent years. Data recently published by the National Institutes for Health (NIH) shows that at least 251,000 patient deaths are estimated to be attributable to physician mistakes or other types of medical errors annually. Countless others fall ill or suffer injuries while […]

Read More

Ohio Car and Booster Seat Laws

According to the National Highway Traffic Safety Administration (NHTSA), traffic crashes are the leading cause of death and disability for children (aged 0-14) in the United States. But most of these deaths can be prevented. When we put our children in the car, we owe it to them to give them the safest experience possible. […]

Read More
Tad Thomas on The National Crime Victim Bar Association
National Civil Justice Institute - Trustee
Tad Thomas on Lawyer Minds
Tad Thomas on American Association for Justice
Southern Trial Lawyers Association
Illinois Trial Lawyers Association
Ohio Association for Justice
Kentucky Justice Association
Fellows of the Litigation Counsel of America
Martindale Hubbell Preeminent
2021 Public Justice Member
AAJ Masters of Trial Law: Champion