Aetna is Sued for Refusing to Cover the Costs of Anorexia
The New York Times has reported that a couple has sued Aetna Insurance Co. on wednesday claiming that it refused to cover fully their daughter's treatment for anorexia. Cliff and Maria DeAnna of Mountainside, N.J., the parents of the sick young woman, said Aetna refused to pay for nearly 10 weeks of their daughter's inpatient treatment, saying her eating disorder was not "biologically based."
The New Jersey family is seeking class action status for their legal claim. In many cases, insurers have refused coverage for mental illnesses that they say do not have a "proven" physiological basis. As a result, these insurers have invited litigation for their failure to provide coverage. The family believes that many other sick individuals have been denied coverage, and thus is asking the Court to provide class action status for this case.
The New Jersey parents said that their daughter had been hospitalized for 101 days so far this year but that Aetna U.S. Healthcare H.M.O. would pay for only 35 inpatient days. Symptoms of anorexia include excessive dieting and exercise and a distorted belief that one is overweight.
A spokeswoman for Aetna said the company was not yet in a position to comment.
The National Association of Anorexia Nervosa and Associated Disorders, a nonprofit organization which seeks to alleviate the problems of eating disorders, believes that insurance companies, in their policies, must take into account both the physical and psychological repercussions of these disorders.
The civil justice system recently has been used by some consumers to obtain fairness. A judge in a 1989 case against Blue Cross and Blue Shield of Greater New York ruled that starvation resulting from anorexia is a physical state that should be covered by medical benefits.
In 2001, Blus Cross agreed to pay $8.2 million to the state of Minnesota to settle a suit filed by the state involving treatment denied to a 21-year-old anorexic woman who committed suicide. Her family paid for her treatment but sued Blue Cross for refusing to pay for it. The insurer also settled with the family for $1 million.