Insurance complaint

[Oceanbreeze]

I'm basically letting off steam, feel free to comment if you want. I'll break it down simple.

1. 2003- Insurance said they would pay for a medical piece of equipment, we purchased it, then they denied it. $4k out of pocket.
2. 2003-2005- We wrote appeal, after appeal. Insurance company "We lost this, we lost that", ect.
3. 2006-we demanded a formal hearing. Insurance company said my husband, a lawyer, can't represent me, conflict of interest. The medical equipment company provided me with a lawyer, company representatives, and expert witnesses for the formal hearing.
4. 2007-March-The hearing is set in San Diego, CA. The Judge travels from DC, the company travels from FL, the lawyer from OH, we drove 8 hours. The expert witnesses (doctors) were in San Diego. We all showed up. Guess who didn't? Got that right, the Insurance company who denied our 14 appeals.
5. 2007-July; The judge made his ruling, he allowed the insurance company rebuttal via mail. The Judge gives the insurance company 3 months to give us the decision.
6. 2007-December-The Judge ruled in my favor, the Director of the Insurance company did not. DENIED.
7. We now are going to appeal to the Senate Armed Services Committee.

Why? My insurance will pay for a $30k brain surgery for me, but not an invasive medical piece of equipment? It's FDA approved, medical coded, yet my medical insurance won't pay for it. We can afford the $4k....what about those who can't and have to have the surgery? Sad world. :sad

[Semantics]

The Judge ruled in my favor, the Director of the Insurance company did not. DENIED.

Why do they even let you go through the hassle and expense of court of they can just deny it anyway?

What a crock. :(

[MW]

Insurance companies totally suck!

[issac the dragon]

Is this the best America can do? I think not. We need socialized medicine.

[Oceanbreeze]

Is this the best America can do? I think not. We need socialized medicine.

Issac; We're still fighting it....it's principal. It's not for me, it's for people who can't afford the $4k medical equipment, but don't want the surgery. It's major surgery with only a 30% success rate. I just don't understand how the insurance company could still say NO? Who is the almighty entity...who controls his strings?? As my medical equipment contact has said, the "Almighty entity" has to be striken with the aliment themselves or loved one to actually KNOW . Canada covers it, I'm quite certain the UK and Aussie's don't. :sad

[cassandra]

Blessings to you OB as you continue to fight this fight. I hope that somebody will finally see that this is something that is needed.

[Kurtz]

I can't even speak to this matter. :twitch

My sympathies, OB.

[Oceanbreeze]

Thanks, everyone.

We have some heavy hitters on our side, it may take awhile, but,ummmm hubby and I are anal retentive. :lmao

[nixon]

Is this the best America can do? I think not. We need socialized medicine. People like Jack Abramhoff are the real problem, there is too much money in passing legislation against the working class individual. Not just health insurance, but also in homeowners and auto and workers' compensation insurance. I've seen the insurance industry make some hefty contributions to campaigns here in Florida, especialy to the closet fag right.

[Partyless]

Is this the best America can do? I think not. We need socialized medicine.

It'll never happen. Insurance companies are so far in bed with the FDA and Congress I'm surprised they haven't produced little bastard children yet. Universal healthcare won't happen in this country until something really really drastic occurs because the corporate greed and political corruption that generates the big bucks won't allow it.

Nice talk by the candidates, though - no shit we need healthcare reform. If someone would address the elephant in the room and come up with a viable plan - like DRASTICALLY reforming the insurance industry and reigning in the FDA dipshits, we may have a prayer. Until then - it sucks!