Health Insurer to Pay La. Woman More Than $2M

May 6, 2005

A health insurance company has been ordered to pay a Louisiana woman more than $2 million for delaying the discovery of a spinal tumor, according to the Associated Press.

Christaine Hymel, of Mandeville, had to delay an MRI for three months to raise part of the $4,000 fee on her own after Blue Cross Blue Shield of Louisiana refused to pay for the test, said Paul Lea, her attorney.

The delay allowed a previously undetected spinal tumor to grow to a point that left Hymel debilitated and required immediate surgery. After extensive physical therapy, she’s able to walk despite nerve damage and irreparable numbness from the chest down, Lea said.

A state district court jury handed down the verdict in February and was affirmed Tuesday by State District Judge Martin Coady.

Blue Cross must pay Hymel $2 million for mental anguish and loss of enjoyment of life, $50,000 for pain and suffering, $69,830 for past medical expenses, and $15,000 for future medical expenses. The company also must pay $101,600 for Hymel’s legal fees.

The verdict is not subject to the state’s $500,000 cap on malpractice awards.

During the trial, Blue Cross alleged that Hymel misrepresented her medical history, deleting references to leg and back pain in her application for coverage. Blue Cross had refused to pay on the grounds that back pain and numbness that Hymel suffered was a pre-existing condition.

“A number of board-certified physicians reviewed Ms. Hymel’s claims and determined that, under the provisions of Louisiana law, her condition was pre-existing,” Blue Cross spokesman John Maginnis said. “Therefore, we believe we made the fair and appropriate claims decision regarding her benefits.”

Hymel said she did not go to court for a payoff.

“It’s more about doing it for the next set of people that are going to be coming through and fighting the insurance company, just to show them that what they did was wrong,” Hymel said.

Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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