Kate Weissman isn’t a household name just yet, but the 33-year-old has embarked on a mission that once concluded, could change the landscape of healthcare. On March 26, Kate, under representation from the renowned litigation firm Callahan & Blaine, filed a class-action lawsuit against UnitedHealthcare (UHC) to challenge what she alleges to be unfair and deceptive policies and procedures for determining whether a prescribed treatment or medication is medically necessary (utilization review). The lawsuit is the result of an arduous battle between Kate and UHC in which UHC denied covering a potentially lifesaving treatment for Kate — and she is taking a fearless approach to challenging a 150 billion dollar industry giant in the interest of securing better healthcare options for countless Americans.
“Kate was successful in a fight for her life and is now prepared to fight for change and hold UnitedHealthcare accountable so that others suffering from life-threatening illnesses will not have to agonize over wrongful coverage denials and crippling medical bills when they should be focusing on their survival and recovery,” says attorney Rich Collins.
October of 2015 was a month that forever changed Kate’s life. At 30 years old and happily married to her husband, Matt, Kate was diagnosed with stage IIB cervical cancer. With the support of a team of skilled doctors and oncologists, and her loving family, Kate began the battle for her life. She was put on standard chemotherapy and radiation treatments, but just a few months later a biopsy revealed that the cancer had spread to her paraaortic lymph nodes. Surgery to remove the lymph nodes was successful but the presence of additional cancerous tissue required removal, and the tissue’s proximity to Kate’s internal organs demanded precision techniques.
In the interest of reducing risk to Kate’s organs, her veteran oncological team recommended a treatment called proton beam radiation therapy (PBT). PBT is an established form of treatment that is widely accepted by physicians, government agencies and many insurers and other payers, including Medicare and Medicaid. But UHC denied the request and Kate was forced into a lengthy appeals process — a process she ultimately suffered through before being denied 6 separate times. Kate and her team of specialists were mystified by the rejections as they felt they’d made a strong case for PBT’s efficacy. “What was shocking to me was that each time I received another letter of denial, the medical directors reviewing were not comprised of radiation oncologists. My six oncologists, the best in the country, were appealing to doctors that did not even specialize in what we were fighting for. This is bad faith conduct, and it is infuriating,” Kate says.
Ultimately Kate’s mother and father tapped into their retirement savings and withdrew the $95,000 required to pay for the lifesaving PBT. Treatment was a success, and today Kate has been cancer-free for over two years. But the experiences Kate had in dealing with UHC left her motivated to enact change against a system she views as deeply flawed. “Insurance companies neglect to uphold their duty to their customers, who are often patients fighting for their life, all of the time. These companies assume and rely on the fact that most patients do not have the time or resources to go up against them, so they get away with this negligence and carry on with their corrupt processes and protocols.”
Kate’s story has been featured in a CNN article, and has resonated with numerous Americans who have faced similar struggles. “Ever since I shared my story publicly this past summer and my public response against UHC, the support has been overwhelming. The common response is outrage, but unfortunately, my story is relatable to many. It is difficult to read all the comments and learn the magnitude of the problem – there are an absurd number of people that have been impacted by their insurance company’s negligence the way that I was. In many cases, though, they were unable to afford the treatment and have had to suffer the consequences.”
Kate and her expert legal team from Callahan & Blaine are fighting to ensure that the most qualified voices are making decisions regarding patients’ treatment outcomes — that the decision does not begin and end with the insurance company motivated by maintaining a healthy bottom line. And while the outcome of her lawsuit is uncertain, Kate is pursuing her new-found advocacy role with conviction. She volunteers for the cervical cancer group Cervivor and lobbies on behalf of cancer research legislation. A beacon of hope undertaking a herculean fight, she is galvanized by the feedback she receives through her outreach. “Every comment I read, every email I get, and every phone call I receive fuels my fire to fight against UnitedHealthcare and their inadequacies.”
Read the full complaint.
If your insurer has denied you or a loved one vital, life-saving treatment, we urge you to join our fight. Contact Rich Collins at 714-241-4444 or rcollins@callahan-law.com for expert legal counsel.
