Home » Children and Youth Articles » Van Nocker Family Files Complaint Against HealthAmerica Insurance Company Seeking Coverage of Cancer Treatment for their Five-Year-Old Son
Van Nocker Family Files Complaint Against HealthAmerica Insurance Company Seeking Coverage of Cancer Treatment for their Five-Year-Old Son
HealthAmerica has denied coverage of treatment doctors call "medically necessary" to save the life of Kyler Van Nocker.
PHILADELPHIA, PA, February 11, 2010 /Children and Youth PR News/ -- Today Paul and Maria Van Nocker, along with their five-year-old son Kyler, filed a complaint against Harrisburg-based HealthAmerica insurance company on the grounds that the company breached its obligations and duties when it denied coverage of a potentially life-saving cancer treatment for Kyler.
"The doctors told us that Kyler needed this treatment to save his life, but HealthAmerica said it wouldn't cover it," Paul Van Nocker said. "That is unacceptable. We will use every resource available to get him coverage for this treatment and we won't stop until HealthAmerica does the right thing."
Doctors say that MIBG treatment is standard care for a child in Kyler's position, but HealthAmerica repeatedly denied the claim because it deemed the procedure "experimental" according to internal guidelines. The Van Nocker family, of Edgewater Park, NJ, never saw those guidelines as part of their insurance plan, and is now seeking coverage for the treatment.
"If we've learned anything from the health care debate, it's that insurance companies will stop at nothing to protect their bottom line," observed David Senoff of the firm Caroselli, Beachler, McTiernan, and Conboy, the Van Nocker's attorney. "They will even go so far as to deny coverage of a life-saving treatment for a five-year-old boy. Insurance companies will only act when forced to do so. That's why we have to turn to the justice system for help."
Kyler was diagnosed with nueroblastoma, a rare and particularly lethal form of childhood cancer, in 2007, when he was about 2 ½ years old. He spent a year in and out of the hospital, and underwent various treatments including chemotherapy, radiation, and multiple bone marrow transplants. His treatment was successful, and his cancer was in remission by September 2008.
In September 2009, tests revealed that the cancer had returned. Kyler's physicians at the Children's Hospital of Pennsylvania (CHOP) recommended that he undergo MIBG therapy, the only known effective treatment option for child with relapsed refractory neuroblastoma.
In direct contradiction of the advice of medical professionals, the HealthAmerica insurance company denied the treatment, calling it "experimental" and "not medically necessary."
According to Kyler's physicians, MIBG treatment in children with refractory neuroblastoma is medically necessary and is not investigational or experimental. The Van Nockers are seeking the coverage they are entitled to under their plan with HealthAmerica.
Despite HealthAmerica's decision, CHOP provided the MIBG treatment in November and December 2009 and it has had the positive effect of impeding the spread of the cancer and reducing its severity in Kyler's system. The Van Nocker family is now responsible for the cost of the treatment.
Visit Caroselli, Beachler, McTiernan, and Conboy's Web site, http://www.cbmclaw.com, for further information.
Contact:
Mark Nevins, (267) 234-7334
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