Hilary Swank Settles SAG-AFTRA Health Plan Lawsuit After Being Denied Coverage for Ovarian Cysts
Hilary Swank has reached a settlement in her lawsuit against the board of trustees of the SAG-AFTRA health plan after being denied coverage for the treatment of ovarian cysts. New court docs obtained by ET show Swank and the board of trustees of the SAG-AFTRA Health Plan have entered into a written settlement agreement to resolve the matter and dismiss any further legal action.
The details of what the settlement entails have not been made public at this time. ET has reached out to reps for Swank and SAG-AFTRA for comment.
In an Instagram post shared last September, the 47-year-old actress revealed that she sued the board of trustees of the SAG-AFTRA Health Plan after being "truly exhausted by the way women’s ovarian and cyclical health issues continue to be treated by healthcare insurance companies."
"I have experienced it in my own life, and I continually read about it across social media and in the press," she wrote in the 2020 post. "Their policies are antiquated, barbaric and primarily view the role of women's organs solely as a means for procreation."
By suing the board, Swank said she hoped to "create change for all woman suffering from women’s health issues that have to battle with insurance companies who diminish the significance of their problems, don’t believe the patient (or their doctor's) explanations surrounding their suffering, and severely preclude coverage to only incredibly limited services and procedures."
The lawsuit alleged that Swank was diagnosed with cysts in 2008 and the insurance company stopped accepting claims for the condition in 2015, around the time she was "undergoing procedures to preserve her ability to conceive in the future."
"Seizing upon Swank's choice to keep her options open, the Trustees pointed to an exclusion in the Plan for 'infertility treatment,' relying on the notion that the only purpose of preserving the health of an ovary is to procreate," the docs read. "This matter addresses the shockingly antiquated question of whether the sole purpose of a woman, specifically her ovaries, is to procreate."
"When faced with a claim for insurance benefits for medically necessary treatment of ovarian cysts and endometriosis, the Trustees answered 'yes,' determining that there could be no possible reason to treat those conditions other than for the purpose of trying to conceive," the docs continued.
Even after Swank and her doctor explained that the actress was not seeking the treatment for fertility purposes, the court docs alleged that "the Trustees dug in their heels... [and] repeatedly said that there was no medically necessary reason to treat or monitor ovarian cysts other than for 'infertility treatment.'"
In a statement to ET last year, the SAG-AFTRA Health Plan said that "contrary to the allegations in Ms. Swank’s complaint, the SAG-AFTRA Health Plan does not exclude treatment for endometriosis and ovarian cysts under the Plan’s infertility exclusion but rather covers diagnosis and treatment of endometriosis and ovarian cysts when medically necessary."
"As reflected in the complaint, the accredited Independent Review Organization (which is a completely separate entity from the Plan) reached the same conclusion as the Plan’s Trustees that Ms. Swank’s services were not medically necessary in this case," the statement added.
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