Keep Our Families Safe

The Growing Problem of Insurance Underpayment 

Are you confident that your insurance company is paying for all that it should?
 
Before you say yes, listen to the story of Carol Abourezk.
 
Diagnosed with soft tissue sarcoma, a form of cancer, in 1997, Abourezk thought that her insurance policy would cover her cancer treatment and her related travel costs. But her insurance company refused to pay for her travel and even refused to pay for some of the costs of her treatment, arguing that it was experimental and thus not covered in her policy. 
 
Abourezk’s brother, South Dakota attorney Mike Abourezk took on her case, vowing to force his sister’s insurance company to meet its obligations. What he did not realize is that he was on the verge of uncovering a much bigger and much more widespread problem of unpaid benefits.
 
Working with co-counsels, Peter Kahana, Richard Friedman, and Michael White,
he quickly discovered that not only had Abourezk’s insurance company, Central States Health & Life Company (CSO) of Omaha, Nebraska, failed to pay for travel and lodging expenses, but it also failed to pay for other non-experimental chemotherapy costs, totaling $100,000.
 
In forcing them to the table, Abourezk uncovered more cancer patients who were being mistreated by CSO.
 
He found one man who underwent surgery to have cancer in his prostate removed. But during the surgery, doctors discovered that his cancer had spread. They decided against removing the prostate because they did not want to make a terminally ill patient incontinent as well. CSO refused to pay for the surgery explaining that it only agreed to pay to have the cancer removed.
 
Abourezk continued to find more and more patients who had been under-compensated by CSO. He explained to one of his clients, Kay Bergonzi, that she could either proceed with an individual case or pursue a class action suit. Bergonzi opted to file a class action on behalf of her and 1,200 other people.
 
CSO finally settled the case for $20 million. Of that amount, $7.5 million goes to the 1,236 plaintiffs who were underpaid, and $9.6 million will go to paying participants under the disputed policy who are diagnosed with cancer in the future.
 
Abourezk is refusing to take any fees in this case, except in instances where the plaintiffs receive more than the amount they were underpaid. Further, he has decided to use his earnings to fund the initial costs of other bad faith insurance cases. 
 
“All of these people, like my sister, were easy to underpay and get away with it, because they are deathly ill and have no room in their increasingly short lives to focus on money,” Abrourezk said.
 
The story of Carol Abourezk and Kay Bergonzi and their lawyers illustrates an important point: You can fight city hall or, in this case your insurance company if it doesn’t play fair.