Imagine you are going on vacation and you pay your neighbor to tend to the hanging plants you have outside of your house. While you’re gone the weather turns and a frost sets in, eventually killing all of your plants. You return home and are understandably distraught to find out that your neighbor neglected to bring your plants indoors, allowing them to perish in the harsh elements. You promptly file vandalism charges against your neighbor for the damage done to your plants. I’d wager that no court, (even one in California) would agree to hear a case on those grounds. I am willing to bet, however, that California courts will entertain the murder charges that the family of Nataline Sarkisyan plans to file against their health care provider, CIGNA.
Suffering from leukemia, complications from a previous procedure, and a failing liver, 17 year old Nataline died on Thursday December, 20th after her family removed her from life support. The family plans to sue CIGNA becuase they claim that she would not have died had CIGNA approved coverage for the liver transplant that she needed. CIGNA, at first denied the request, claiming that because of Nataline’s illness, the complications from a previous surgery, and likely interaction of medications, that a liver transplant in her case would be “experimental” and the likelihood of success small–putting the surgery beyond the scope of the family’s coverage under CIGNA. But, after protests and loads of negative publicity, CIGNA decided to reverse it’s decision and grant the transplant. Nataline died hours after the decision (after her family removed her from life support).
As we don’t yet know all the details surrounding Nataline’s death, I will abstain from assigning blame, but I want to address those other commentators who place responsibility for her death squarely on CIGNA. Put simply, insurers have no responsibility to save lives. That is not what we pay them for. The only duty an insurer has is to pay for medicine and procedures agreed upon in the contract. If CIGNA broke the contract it had with the Sarkisyans, then by all means they ought to be sued, but not for murder, manslaughter, nor negligent homicide. CIGNA did not cause Nataline’s leukemia, and it did not prevent the family from receiving the transplant they claim would have saved her life, they simply declined to pay for it. The family had no right to CIGNA’s funding beyond the contract that they signed with the insurer, and by CIGNA’s account, the surgery was beyond their plan. Understanding that the surgery would have cost a massive amount of money, potentially a hundred thousand dollars or more, the family still had a choice to find alternative means of funding for the surgery.
The bottom line is that CIGNA, and any other insurer, is only responsible for providing financial coverage as their contract stipulates; nothing more.