Jury Awards $200 Million Against Sierra Health & Life for Wrongful Denial of Healthcare Coverage

I want to thank you all for the very kind words and thoughts. Those comments are greatly appreciated. I want to let you all know briefly what Eskew v. Sierra Health & Life was about. I am sure there will be a time when I have the energy to talk about the trial strategy, the trial, and our impression of why the jury made the right decision.

Three years ago, Doug Terry (a great lawyer from Oklahoma City) and I believed in a fine lady from Las Vegas, Sandy Eskew, and Sandy Eskew believed in Doug and I. This case stems from Sandy’s husband, Bill Eskew’s diagnosis and treatment for his lung cancer, and how his insurer, Sierra Health & Life (SHL), handled his claim for treatment.

On February 4, 2016, Bill’s world-renowned radiation oncologist recommended a type of radiation therapy called proton beam therapy. SHL had a hidden medical policy written by corporate bureaucrats that was illegally used to conclude that any claim for proton beam therapy for lung cancer, and many other types of cancer, would automatically be denied for lack of medical necessity. On February 5, 2016, SHL denied Bill’s preauthorization request for proton beam therapy without consideration of the insurance contract and without investigation.

Bill was forced to undergo an alternative radiation therapy called IMRT. This therapy caused a serious injury to Bill’s esophagus. Over the next year of his life, Bill suffered tremendously. He could not eat consistently; food got stuck in this throat. As you might think, the inability to eat impacted other aspects of his health. At trial, the family testified about how Bill withdrew and became isolated as he suffered from the complications of esophagitis and was burdened with the knowledge that a bureaucrat decided he knew more than a world-renowned doctor. Bill died in March 2017 from the cancer and reasons unrelated to the IMRT.

Through discovery, Doug and I uncovered a systematic claims process where SHL automatically denied claims without consideration of the duty of good faith and fair dealing and with knowledge that insureds would suffer and even die.

Sandy Eskew filed this lawsuit to give meaning to Bill’s suffering and with hope that no one else has to suffer like Bill. The litigation was hotly contested. The trial was hotly contested. SHL was represented by Weinberg Wheeler. SHL’s defense essentially was SHL needed to engage in managed care to keep insurance affordable and Bill, while he suffered from lung cancer, was not injured by the IMRT.

We filed this case as a survival action. The jury returned a compensatory award of $40,000,000 for Bill’s pain, mental suffering, loss of enjoyment of life, and emotional distress. The award reflects the reasoned judgment of what pain and suffering really means when an insurance company takes away your dignity in your last days on this earth and dignity you can never get back. It goes back to what Moe Levine said: it is not what the defendant took from your client that matters; it is what the defendant left your client with that matters.” SHL left Bill with nothing but a shell of himself.

The jury awarded $160,000,000 in punitive damages. The award reflects the reasoned judgment of what was necessary to punish and deter an insurance company who deliberately did what it did to its insured for money and with the conscious belief that it was above the law.

In addition to all our witnesses, Doug Terry and I want to thank our staffs, everyone at Friedman Rubin, John and Alicia Campbell – who did our focus groups, Seton Claggett at Focus Graphics and his staff who helped our expert create compelling demonstrative exhibits, and Jason Sanderson with E-deposition who is a great trial technician.

There (are) also many on the list serve who provided us with support: Christian, Micah, Sean, Rahul and many others. What happened on Monday and Tuesday of this week in a courtroom in Department 4 in the Eighth Judicial District Court was important for Las Vegas and our entire state. This courageous jury will have an effect upon the insurance industry.

Doug Terry and I are so grateful that the jury gave justice to Sandy Eskew.