Don't Let Health Insurers Get Away With Murder

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Tell the U.S. Congress that it must close a legal loophole that bars most Americans from holding their health insurance company financially accountable for unjust denials of necessary care. The lack of accountability allows HMOs and insurance companies to deny access to care without fear of reprisal.

"I want to get rid of this ERISA law," Hilda Sarkisyan, Nataline's mom, told the Los Angeles Times, "and replace it with Nataline's law."

Mrs. Sarkisyan was unable to take CIGNA to court after Nataline died following CIGNA's denial of a potentially life-saving liver transplant.

 
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Message:

Subject: Don't Let Insurers Get Away With Murder
Dear Lawmaker:

Recently a federal court threw out a lawsuit brought by the family of Nataline Sarkisyan who died December 20, 2007 when CIGNA refused to pay for her liver transplant.

HMOs and health insurers face no financial consequences for denying medical claims brought by 132 million Americans who receive health coverage through a private employer. Health care reform must close this loophole.

Under the Employee Retirement Income Security Act (ERISA) and a 1987 Supreme Court decision in Pilot Life Insurance v. Dedeaux, victims can only recover the cost of the procedure or service denied in the first place—no damages or penalties are allowed.

As a result, HMOs and insurers are largely free to deny access to care without fear of reprisal or financial consequences. For example, since Nataline's liver transplant didn't take place at all, the family would not have received anything even if they'd won.

On June 19, 2001, Senator Kennedy gave his opening speech to the U.S. Senate on a bill which would have allowed patients to hold health insurers financially accountable when they cause harm. Kennedy told you, his colleagues:

"No other industry in America enjoys immunity from accountability for its actions, and the insurance industry does not deserve it either. Few, if any, provisions will do more to guarantee that your HMO does the right thing than the knowledge that it can be sued if it does the wrong thing."

However, none of the current health reform bills provide legal accountability of health insurers.

Any health care overhaul must overturn Pilot Life and end health insurer immunity.
Sincerely,

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Watch a video clip of former CIGNA insurance executive turned whistleblower, Wendell Potter, telling the story of Nataline Sarkisyan.

Read the Los Angeles Times story about Nataline's parents' struggle for justice.

Read Consumer Watchdog's letter to Congress demanding HMO and insurer accountability in health reform.

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