Cancer Patient Says Insurer, Medical Group Denied Him Life-Saving Treatment
LOS ANGELES (CBSLA.com) — A 49-year-old man says his insurance company and health care administrator repeatedly denied him a medical procedure that could have prevented his cancer from advancing to the point where he’s now considered terminal.
“The scale of damage to my face would not be this much if it was addressed in time,” Arkadia Amiryan said.
In October 2011, Amiryan noticed a lump and went to see his doctor.
“I had a tumor in my upper palate and I got pain. It was just a bump,” he said.
The bump, however, turned out to be a 2-centimeter by 2-centimeter tumor.
Doctors recommended Amiryan get a biopsy immediately.
His providers, Health Net and Associated Hispanic Physicians, wouldn’t approve the procedure, Amiryan said.
“I remember crying on the phone. I remember begging on the phone to send me to a doctor,” he said.
In May 2012, with no insurance approval, Amiryan paid for the biopsy on his own.
Doctors then told him he needed to have surgery as soon as possible.
“It’s a pre-cancer condition, so you need to remove the tumor as soon as possible,” Amiryan said.
It took until July 2012, 10 months after the original tumor was discovered, for Amiryan’s insurance to approve the surgery and the doctor.
By that time, Amiryan said it was too late, as doctors told him the tumor had turned cancerous and metastasized.
“There is no cancer here now, but it spread to my bones,” Amiryan said.
CBS2’s Andrea Fujii reported the delays didn’t end there.
Doctors ordered radiation to start 14 days after surgery, but Amiryan said because of insurance holdups, he had to wait seven weeks.
According to paperwork, the insurance providers claimed there was no medical necessity and his requests didn’t meet the criteria for expedited review.
The Amiryan family is now suing Health Net and Associated Hispanic Physicians.
“I am absolutely sure that if they were intending to help him earlier, he would not be in this condition now,” said Amiryan’s wife, Lilly.
California health codes require insurance providers to respond to procedure requests within 72 hours if the patient faces an imminent threat to his health, reported Fujii.
“Very frustrating. I mean, you’re talking to insurance and they kept saying, ‘No, you don’t need it,’” Amiryan said.
Amiryan’s attorney, Travis Corby from Shernoff Bidart Echeverria Bentley, said this is the most egregious case of bad faith he’s seen.
“He just was met with delay after delay and his minor medical condition is now going to cost his life,” Corby said
Though they believe he’ll beat the odds, the Amiryans say they’re now fighting for justice, especially for their two young children.
“If something happens to me, if I die, what’s going to happen to them? Who’s going to support them?” Amiryan said.
“My husband said, ‘I want that insurance company to be punished, I don’t want them to kill people like me anymore,’” Lilly said.
A representative from Health Net said the company does not comment on pending litigation.
Associated Hispanic Physicians did not respond to repeated calls by CBS2.