They will not pursue an appeal that they’re entitled to. In this case, Nataline Sarkisyan's family did. Cigna still said no. So the company became a, the family became a very squeaky wheel and it became a huge PR nightmare for Cigna and the company eventually relented.

Nataline Mary Sarkisyan (July 10, 1990 – December 20, 2007) was an American teenager with recurrent leukemia. Her case became part of the health care reform debate in the United States in 2007 when Cigna HealthCare denied coverage for a liver transplant operation. The company later reversed its decision after a great deal of media attention to her story, but Sarkisyan died hours later.