A 58-year-old man in the United States died after delays in insurance approval allegedly prevented him from receiving a potentially life-extending cancer treatment in time, according to media reports.Eric Tennant, a mining safety instructor from Bridgeport, West Virginia, was diagnosed in 2023 with stage 4 cholangiocarcinoma, a rare and aggressive bile duct cancer that had spread to other parts of his body.After more than two years of chemotherapy and radiation, Tennant was identified in early 2025 as a suitable candidate for histotripsy, a non-invasive procedure that uses ultrasound waves to target liver tumours.His doctors were ready to proceed, but his insurer, the Public Employees Insurance Agency (PEIA), which partners with UnitedHealthcare, denied coverage, saying the treatment was “not medically necessary.”
Appeals fail, costs too high
Tennant’s family filed multiple appeals, submitting medical records and expert opinions, but the requests were repeatedly rejected.The procedure would have cost around USD 50,000 out of pocket, forcing the family to consider dipping into their retirement savings. “People should not have to beg to get help, especially for something that they are already paying for,” his wife Rebecca was quoted as saying.While the family did not expect a cure, they believed the treatment could have extended Tennant’s life and improved its quality.The insurer eventually reversed its decision in May 2025 — reportedly after media inquiries — but by then Tennant’s condition had deteriorated. He was no longer eligible for the procedure.He was later placed in hospice care and died in September 2025.“He wasn’t afraid to die, but he didn’t want to die,” Rebecca said. “You could tell the last day that he was fighting it.”The case has drawn attention to the controversial practice of prior authorisation, under which insurers must approve treatments before they are carried out.A report by KFF found that over a quarter of US physicians surveyed said prior authorisation had led to serious adverse events in patients. About 8% said it resulted in disability, birth defects or death.Insurers argue the process acts as a safeguard to ensure appropriate use of treatments, especially newer or experimental ones.UnitedHealthcare said there is limited evidence on the effectiveness of histotripsy and its impact on survival.Tennant’s case has since prompted legislative action in West Virginia.A new law, signed on March 31 by Governor Patrick Morrisey, allows patients to opt for medically appropriate alternative treatments of equal or lower cost without requiring fresh approval.The law also mandates faster response timelines for urgent cases and is set to come into effect on June 10.Lawmakers said the move aims to reduce delays during critical treatment windows and give patients greater flexibility in care decisions.Rebecca Tennant said earlier access to histotripsy could have helped control the tumour in her husband’s liver.“The insurance company’s decision did not simply delay care. It closed doors,” she said.
