P.M. BRIEFING : Federal Judge Orders Insurer to Pay for New Anti-Cancer Treatment

Two insurance companies that refused to pay for an expensive new anti-cancer procedure today were ordered to reverse their positions immediately and allow treatment to begin in an attempt to save the life of a man with a fatal bone marrow malignancy.

A federal judge rejected the arguments by Crum & Forster Organizations and Prudential Insurance Co. of America that the treatment is experimental. He ruled that the insurers, in refusing to pay for the treatment, had failed to abide by the language of their own policy.

“If a preliminary injunction is not granted, ultimate relief will be too late,” U.S. District Judge Dickinson Debevoise said in ruling in favor of cancer patient Nicolae Dozsa.

Dozsa, 54, was accepted in December for autologous bone marrow transfer at Johns Hopkins Hospital in Baltimore after he stopped responding to conventional chemotherapy. He has been unable to receive the treatment because Crum & Forster, the insurance company for which his wife works, refused to cover it, ruling that ABMT is still experimental for patients with multiple myeloma.

Debevoise ordered Crum & Forster and Prudential, which administers the Crum & Forster plan, to notify Johns Hopkins immediately that Dozsa would be covered.