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Jury Holds Insurance Company Responsible for Patient’s Opioid Addiction

health net insurance sued after delays in treatment lead woman to opioid addictionA Los Angeles County jury awarded both punitive and compensatory damages to a woman who sued her insurance provider alleging that delays in its approval of her care led to her becoming addicted to opioids.

The patient had been made to wait for months on end for a surgical procedure to correct a condition that put her in constant and intense pain. Rather than approve the procedure that would remedy the condition and correct the issue, the insurer delayed her request for months, and only approved the administration of powerful narcotics to treat the pain.

The plaintiff eventually sued her insurance provider, Health Net, after multiple attempts to get the procedure covered. While her doctors and medical team wanted to see her treated in a matter of weeks, analysts sitting at desks at Health Net repeatedly delayed each request.

Once approved for opioids to treat the pain, the plaintiff again contacted Health Net stating that she did not want to be on opioids for an extended period of time and asked for the procedure to be approved. Rather than approving a medical procedure that had been recommended by medical professionals, the insurer delayed her procedure once again, this time by an astonishing six months.
Months of taking powerful prescription narcotics led to a predictable outcome: she became opioid dependent and addicted to the medication.

Having finally received the surgery to treat her actual condition, the woman then sued Health Net for the delays and resulting opioid dependency. After reviewing the facts, a jury agreed and found that Health Net had delayed or denied care without any proper cause and caused harm to her. $6.9 million was awarded in compensatory damages with an additional $7.5 million awarded in punitive damages against Health Net.

The insurer is considering an appeal and calls the verdict “flawed.” After delaying a patient’s treatment to the point of her becoming dependent on prescription narcotics, the company released a statement saying that it will “continue to vigorously defend [its] position in court as well as [its] record of providing quality care to millions of Californians.” Apparently at Health Net, “quality care” means contributing to the opioid epidemic and preventing doctors from treating their patients.