Professional Negligence Law Reporter

William Eskew, 65, developed Stage IV lung cancer. His treating physicians recommended proton beam therapy, and a preauthorization claim was made to Eskew’s insurer, Sierra Health and Life Insurance Co., which conducted a utilization review and denied coverage. Eskew underwent an alternative therapy, which caused a burn injury to his esophagus. This led to the development of scar tissue, which interfered with his ability to swallow, resulting in weight loss and emotional distress until his death a year later.

Eskew’s estate sued Sierra Health and Life Insurance Co., alleging bad faith. The plaintiff asserted that the defendant had a process to automatically deny claims and had no procedure in place to investigate individual insureds’ cases, including that of Eskew, who met the criteria for proton beam therapy—a medically necessary treatment not excluded under his insurance policy. Moreover, the plaintiff asserted that the defendant had a hidden corporate policy to deny claims for proton beam therapy.

The jury awarded $200 million. The court denied posttrial motions and entered judgment for more than $206 million.

Citation: Eskew v. Sierra Health & Life Ins. Co., No. A-19-788630-C (Nev. Dist. Ct. Clark Cnty. Oct. 24, 2022).

Plaintiff counsel: AAJ member Matthew L. Sharp, Reno, Nev.; and AAJ member Douglas Terry, Edmond, Okla.

Plaintiff experts: Andrew Chang, radiation oncology, San Diego; Stephen Prater, insurance, San Jose, Calif.; and Zhong Xing Liao, radiation, Houston.

Defense experts: Amitabh Chandra, economics, Cambridge, Mass.; and Parvesh Kumar, radiation oncology, Kansas City, Mo.