The Largest HMO Verdict
The Largest Ever Verdict Against an HMO: Goodrich v. Aetna
THE GOODRICH CASE, brought by California attorney Michael Bidart on behalf of an Aetna policyholder afflicted with stomach cancer, represents the largest punitive damages award ever against an HMO and sent shockwaves through our country’s managed care system.
At trial, the jury found Aetna guilty of acting with malice, fraud and oppression and punished the HMO with a record-setting $116 million in punitive damages. This award was in addition to $3.7 million for wrongful death and nearly $750,000 for unpaid medical bills.
At issue was Aetna’s repeated refusals to pay for policyholder David Goodrich’s specialized treatments of his rare cancer, called leiomyosarcoma. The treatments were authorized by David’s primary care physician, who was assigned to him by Aetna. Yet with little to no investigation, Aetna simply determined that the procedures were either experimental or too costly and refused to cover them.
David Goodrich died on 15 March 1995, suffering from stomach cancer that had spread to his liver. While fighting for his life, the former deputy DA for San Bernardino County had been forced also to battle his HMO. He passed away fearing that his wife Teresa, a kindergarten school teacher, would be left with all the medical bills.
Outraged by Aetna’s behavior, the jury issued a clear warning to all HMOs in the form of the largest verdict in such a case to date.