$200 Million Verdict Against United Healthcare Exposes Bad Faith in Insurance Coverage

Doug Terry

LAS VEGAS, NV—A jury in Las Vegas handed down an astounding $200 million verdict against Sierra Health and Life Insurance Company, Inc. — and its parent company, United Healthcare, Inc. — after the insurer refused to cover proton beam therapy for a patient suffering from stage 4 lung cancer, despite the treatment’s being recommended by a world-renowned thoracic radiation oncologist at University of Texas MD Anderson Cancer Center in Houston. The patient died a year later.

The verdict was in two parts. On Monday, the jury awarded the estate of cancer patient Bill Eskew $40 million in compensatory damages for his physical, mental, and emotional suffering. On Tuesday, the jury awarded his estate an additional $160 million in punitive damages to punish Sierra Health and United Healthcare for malice and oppression and to send a warning and clear message to other health insurance providers who deny claims in bad faith. UnitedHealth Group has a market capitalization of nearly $500 billion and is ranked 8th on the 2021 Fortune Global 500.

The 63-year-old patient, Bill Eskew, a resident of Las Vegas, was diagnosed with stage 4 cancer in February 2016 and traveled to MD Anderson in Houston to see a high-profile thoracic radiation oncologist who specialized in lung cancer. The surgeon recommended a procedure called “proton beam therapy,” a precision form of highly accurate radiation that attacks tumors while leaving surrounding tissue intact. Because Mr. Eskew had a tumor right next to his esophagus, this treatment was chosen to avoid burning the esophagus, which would make it much harder to eat and swallow medication. A reviewing doctor at Sierra Health, who had no specialization in radiation, denied the claim. Proton beam therapy as a treatment for cancer has been approved by the Food and Drug Administration and is also covered by Medicare.

Because the proton therapy was denied, the family pursued a less-focused radiation treatment called IMRT, which burned his esophagus and caused scarring, making it hard to eat, drink, and swallow medicine. The patient developed stage 3 esophagitis and died in March 2017.

Doug Terry’s co-counsel in the case was attorney Matt Sharp of Reno, NV. The total $200 million verdict was issued in 8th District Court of the State of Nevada for Clark County.

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