Attorney Michael John Bidart's Legal Cases

Health care

Goodrich v. Aetna

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OUTCOME: $120 million verdict

A jury in California yesterday awarded $116 million in punitive damages to a patient's widow who contends he died after a subsidiary of Aetna Inc., the nation's largest health insurer, delayed approvin ... g treatment for stomach cancer that its own doctors had recommended. Lawyers on both sides called it the largest such verdict against a health maintenance organization. Aetna said it was confident that the damages would be overturned on appeal, as would a finding by the jury in San Bernardino County Superior Court last week awarding $4.5 million in actual damages in the 1995 death of David Goodrich, 44, a career local prosecutor. The previous record, an $89 million award in a similar case five years ago, was later settled for a small fraction of the original amount. Mr. Goodrich's case, which comes against a growing national backlash against the restrictive policies of H.M.O.'s, is unusual because most Americans are barred by a 1974 Federal law from suing their health insurer or H.M.O. for any damages except unpaid bills even if treatment they are entitled to is refused. The 1974 law does not even allow collection of legal fees.

Health care

Trading Medicare for HMO

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OUTCOME: multimillion-dollar settlement

A 68-YEAR-OLD MAN assigned his Medicare benefits to an HMO in return for coverage to match or exceed his minimum Medicare benefits. Among the promised benefits were 100% payment of comprehensive inpati ... ent and outpatient rehabilitation services. Six months later, the man broke his hip in a fall. After surgery, he suffered serious complications, including two major heart attacks, pneumonia and a large blood clot in his leg. When he was finally moved out of the intensive care unit, he was still unable to walk or stand. He required extensive rehabilitation, so he was transferred to a rehabilitation facility, where he began a physical therapy program. The HMO questioned the man’s ability to participate in the program and mandated that he be admitted instead to a nursing home, which was less expensive and had no rehabilitation program. The man’s physicians maintained that he needed physical therapy, after which he would be able to walk normally again. The HMO turned a deaf ear, refusing to pay for physical therapy on the grounds that it was medically unnecessary. At this point, attorney Michael Bidart initiated legal action against the HMO. The unanimous support of all three of the man’s doctors—his personal physician, his hospital physician and his hospital psychiatrist – made Bidart’s case exceedingly strong. Moreover, the physical therapy services the man’s doctors recommended were clearly within Medicare guidelines and had been overruled by HMO representatives only because they were getting paid to say no. Three years after filing suit, the man received a multimillion-dollar settlement from the HMO. Fortunately, while waiting for the lawsuit to be settled, he was able to continue physical therapy with the help of a charitable foundation, and he eventually made a full recovery. - See more at: http://shernoff.com/resources/trading-medicare-for-hmo/#sthash.QKGISnRP.dpuf

Michael John Bidart's Legal Cases (2)

Goodrich v. Aetna

Trading Medicare for HMO