Dixit v. Harvard Pilgrim Health Care
GLAD negotiated a successful settlement on behalf of our client after Harvard Pilgrim Health Care refused to cover treatment for the severe lipodystrophy he developed as a result of taking anti-HIV medication.
When Amit Dixit came to GLAD, the powerful anti-HIV drugs that he was taking to keep him alive had brought on severe lipodystrophy, which he found devastating. Large, abnormal growths of fat appeared on his shoulders, back, neck, and under his arms, distorting his body and his face. He lived with this condition and its profound psychological and social impact for a decade.
Yet his insurer, Harvard Pilgrim, would not pay to treat this debilitating condition – saying that removing the fat by liposuction is “cosmetic” only, as though it were a tummy tuck or lip-plumping. While insurers have long paid for plastic surgery for people who have burn injuries, been in car accidents, or require cancer-related breast reconstruction surgery, they continue to trivialize similar needs for people with HIV who are experiencing bodily changes.
GLAD filed an appeal on Amit’s behalf with Harvard Pilgrim, even as we prepared to file a lawsuit. Much to our delight and Amit’s, Harvard Pilgrim reversed itself and agreed to pay for his treatment. He had a successful surgery in April, 2010.