Insurance subscriber accuses Blue Cross of contract breach

By Philip Gonzales | Sep 19, 2016

HOUSTON — A Missouri City man is suing a Blue Cross division, alleging failure to provide coverage. 

HOUSTON — A Missouri City man is suing a Blue Cross division, alleging failure to provide coverage. 

Russell K. Howard filed a lawsuit Aug. 29 in the Houston Division of the Southern District of Texas against Blue Cross Blue Shield of Arizona alleging failure to comply with the provisions of the insurance policy.

According to the complaint, in March 2014, Howard received a diagnosis of prostate cancer. On May 13, 2014, and on May 29, 2014, the suit says, Howard sought pre-certification by Blue Cross for a proton therapy regimen. 

The lawsuit states on June 19, 2014, Howard paid $105,625 for the projected cost of the proton radiation regimen. Thereafter, the complaint says, he received proton therapy treatments together with periodic follow-up blood testing. The plaintiff alleges Blue Cross Blue Shield of Arizona refused to pre-certify and denied payment for all succeeding claims and appeals.

Howard seeks trial by jury, compensation for damages, declaratory judgment that proton radiation therapy was medically necessary, attorney fees, costs of court, and all other relief the court deems just. He is represented by attorney Patrick F. Timmons Jr. of Houston.

Houston Division of the Southern District of Texas Case number 4:16-cv-02622

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Blue Cross Blue Shield of Arizona

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