Surfside victim fighting health insurance company again

A Surfside man who lost his daughter and son-in-law in the building collapse disaster is, once again, fighting a court battle against his health insurance company.

Pablo Langesfeld has stage four pancreatic cancer. A judge already ruled the Oscar Insurance Company must cover an expensive medication, but the Oscar is relitigating the case.

Last April, Langesfeld thought his fight against Oscar was over when the jury, and a month later, Judge Migna Sanchez-Llorens, ruled in his favor.

“No one should have to go through this,” a very frail Langesfeld said at the time.

Last December, Oscar denied coverage for a combination drug therapy called Avmapki-Fakzynja, which costs a staggering $48,500 every three weeks. Langsfeld appealed, was denied three times, so as a last resort, filed a lawsuit, went to court, and won.

But Oscar’s attorneys went back to court today, asking the same judge to overturn her own ruling, which, at the time, they did not appeal. 

“But they’re still unwilling to just let go of this, to leave my client in peace,” said Todd Legon, Langesfeld’s attorney.

Martin Langesfeld was in the courtroom today. He says his father was too ill to attend the hearing.

“His own oncologist still thinks this medication is medically necessary, so I don’t see why we’re still here fighting in court,” Martin Langesfeld said.

Oscar’s attorneys declined to comment after the hearing, but they argue that since Pablo Langesfeld never did take the combo drug therapy, that is newly-discovered evidence which could have led to a different ruling from the judge.

“All we’re doing is following medical advice, nothing else, we’re not attorneys, and we’re not doctors,” Martin Langesfeld said.

The family says Oscar delayed the combo drug for many months, which is why they sued the company in the first place, so doctors enrolled Langesfeld in an experimental drug trial.

“They had to change treatment because, as this doctor said, if they didn’t, he would be dead by now,” Martin Langesfeld said.

The oncologist told the court he may still need to treat Langesfeld with the combo drug therapy, depending on the results of the experimental drug trial. The judge is not expected to rule on this case for another four or five weeks.