Plaintiff whose insurer delayed surgery is awarded $14 million over opioid dependency

A Los Angeles County jury awarded more than $14 million this week to a woman who sued her health insurance provider alleging that the company’s long delay in approving surgery for a painful condition led to her opioid dependency.

Health Net was ordered to pay $7.5 million in punitive damages and $6.9 million in compensatory damages after the jury found that the company had delayed or denied care without proper cause, resulting in harm to the plaintiff, Elaine Courtney.

Health Net, which also administers Medi-Cal health plans, said it was “exploring [its] options to appeal.”

“Health Net believes the verdict in the trial is flawed,” the company said in a statement. “We will continue to vigorously defend our position in court as well as our record of providing quality care to millions of Californians.”

Courtney filed suit against Health Net after her attempts to have surgery for a painful colorectal condition were repeatedly delayed months at a time, her attorney Travis Corby said in an interview.

While Courtney awaited final approval for the procedure, Health Net did not make its specialists available to her, according to the lawsuit. She was eventually prescribed opioid medications for pain management.

Doctors were hoping Courtney would undergo the procedure within four to six weeks of the prescription, Corby said.

Two weeks after receiving the prescription, she contacted Health Net multiple times, asking again for the surgery and expressing a desire to be off the pain medications, but the surgery was put off by six months, Corby said.

“They never did provide her surgery till months later, and she became predictably dependent on the medication and couldn’t kick the habit,” he said.