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CIGNA ordered to pay Texas widow more than $13 million in damages

A Dallas County District Court jury has awarded a Texas widow more than $13 million in damages in a case involving her 83-year-old husband who died after CIGNA HealthCare allegedly forced him out of a nursing home to cut costs.

The lawsuit alleges the 83-year-old man died after CIGNA forced him out of a nursing home to cut costs.

It is the first verdict returned against an HMO under the Texas "patient's rights law," which allows individuals to sue HMOs that they believe have wrongly denies them medical treatment.

According to the lawsuit, CIGNA Medicare HMO member Herschel Pybas "was forced out of [Integrated Health Services of Texoma] by CIGNA" less than a month after being admitted to the skilled-nursing facility, "despite his treating physician's desire that he remain over the weekend."

The lawsuit alleges that CIGNA representatives assured Pybas' doctor that the HMO would provide health care at home. However, when the patient was released, the promised home health care wasn't in place and the oxygen he required wasn't provided. Pybas died the following day.

In a statement, CIGNA says it is "disappointed" with the verdict but it will continue to stand by its employees. "We empathize with Mr. Pybas' family, but believe the decision in this case is not supported by the evidence."

CIGNA is considering its options for an appeal.

Landmark verdict

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Although the Texas patient's rights law was passed in 1997, the Pybas case is only the second HMO lawsuit to go before a Texas jury and the first verdict to be levied against a health insurer. According to Pybas' attorney George Parker Young, most cases filed under this law have been settled before going to trial.

The jury awarded widow Dorothy Pybas $3.05 million in actual damages and another $10 million in punitive damages as a warning to CIGNA and other HMOs about denying their members necessary medical treatment.

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