Tulare fights insurer over $1m hospital bill [The Fresno Bee]
By Lewis Griswold, The Fresno Bee | |
McClatchy-Tribune Information Services |
Sun Life Assurance Company of
But a
If the city loses, it would have to pay the
The city sued the insurance company in November, three months after
Both cases were filed in
In an email response,
The city self-insures up to
"We pay a lot of money for insurance coverage on the reliance they will be there when we need them," Dorman said. "The company is just trying to get out of its obligation."
How much the city paid
Typically, the city pays medical bills, then files a claim. But the city paid
The woman, who died and is not named in court filings, was diagnosed in late 2009 with acute myeloid leukemia.
She was also pregnant.
In 2010, she gave birth to a child, then got the bone marrow transplant. She died after several months of hospitalization.
At the time of the transplant, she was given medication to fight off "graft versus host" disease, a condition common to transplant patients in which the body rejects foreign tissue, the lawsuit said.
She agreed to participate in a clinical trial that involved testing two drug combinations to see which was most effective in fighting the disease.
The insurance company told the city it was denying the claim because the trial involved experimental drugs, which the policy does not cover, said
"We've never seen an insurance company try to deny an entire hospitalization or treatment because of a small portion of the unrelated care," Corby said.
The drugs cost
The reporter can be reached at (559) 441-6104, [email protected] or @fb_LewGriswold on Twitter.
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