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Parents awarded millions. Jury finds health plan uncaring, deceptive
Bob Mahlburg, Star-Telegram
An Irving-based insurance company could be ordered to pay $41.25 million to a Glen Rose couple for refusing to pay for an operation when their 10-month-old baby contracted a rare, potentially fatal disease last year.
A Somerville County jury concluded Wednesday that Sanus Texas Health Plan acted in "conscious indifference" to the infant's health, and the jurors voted to award $13.75 million to his parents, John and Jaye Hedrick. The jury also ordered Sanus to pay another $4.3 million in damages "as punishment and a warning and example to others."
And the Hedricks' attorney, Rickey Brantley of Fort Worth, predicted that the amount will be increased to $41.25 million in the judge's final order because of the jury's finding that the firm knowingly used "deceptive practices" in its business, such as advertising and claim decisions.
District Judge C.C. "Kit" Cooke, who has the final say on the amount, ruled that the $155,000 operation should have been covered by Sanus insurance. Cooke rejected arguments by Sanus attorneys that the care fell under a policy exception.
Sanus attorney Raymond La Driere said yesterday that the firm always "acted in good faith." He declined to comment on the monetary award or the jury's findings that the firm was uncaring and deceptive.
In October, John Bradley Hendrick - now 16 months old was found to have Hurler's syndrome, a rare disease that prevents the body from breaking down protein and typically leads to mental retardation and curved spine, Brantley said. If left untreated, it usually causes death by the age of 10, he said.
The child's father, Dallas firefighter John Dale Hedrick, sought approval under his city health insurance policy for surgery to halt the spread of disease, but Sanus refused.
The child eventually underwent surgery when other city insurance plans picked up much of the cost, Brantley said. But he said the delay caused permanent damage that could have been avoided, including a hunched spine and swelling of the throat that will force the child to eat through a tube his entire life.
"I think they (Sanus) were very cruel and mean," said Jaye Hendrick, 27, who is a former Cleburne grade school teacher.
"I called numerous times and spoke to the insurance company doctor. I said, "Do you realize you're going to kill my child?' It's a very awful feeling when you're trying to save your child's life and he just refuses."
She quit her job, sold some of their furniture and organized community fund-raisers in Glen Rose and with Dallas firefighters to help pay for the surgery. She said she filed the lawsuit so others won't have to go through the same ordeal.
"Of course, we're very thrilled with the decision," she said. "We wanted to make it an amount to the point where it will penalize the insurance company so it won't happen again."
Copyright 1991, 1994 STAR-TELEGRAM INC.
Record Number: FWST18079
