Humana Promised to Cover M.S. Injections, Then Refused, Suit Charges

Humana Insurance Co. induced a Cleveland woman to buy its health insurance by assuring her it would cover her multiple sclerosis medicine, then denied claims for it after the first month and she was hospitalized for two weeks with a flare-up, she claims in Cuyahoga County Court.

Janet Robinson said she was 51 when she was diagnosed with multiple sclerosis in December 2001 and was prescribed daily injections of Copaxone. Medicare and Medicaid policies paid for the injections through 2008, she said, when she was approached by a Humana salesperson who claimed that Humana would provide benefits superior to those she had been receiving.

Robinson said she specifically asked if the Copaxone injections would be covered and was assued they would be. She then enrolled in the Humana health and prescription coverage plans.

The Copaxone and her other medications were covered during the first month of the plan but then, Humana stopped paying for her Copaxone injections, the suit alleges.

In March 2009, after going without her medication because of Humana's denial of her claims, Robinson was hospitalized with a flare-up of her multiple sclerosis.

Upon learning of her hospitalization, Humana attempted to retroactively approve the Copaxone injections but by then Robinson had suffered what she believes to be permanent harm because of the period during which she went without the medication, according to the suit.

The suit seeks payment of $25,000 in compensatory damages plus interest, attorney's fees and compensation for pain and suffering.