[HN Gopher] Big Insurance Met Match When Turned Down a Top Trial...
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       Big Insurance Met Match When Turned Down a Top Trial Lawyer's
       Request for Cancer
        
       Author : thehoff
       Score  : 19 points
       Date   : 2023-11-07 21:43 UTC (1 hours ago)
        
 (HTM) web link (www.propublica.org)
 (TXT) w3m dump (www.propublica.org)
        
       | Something1234 wrote:
       | Honestly, a really good story well written. Should be read by
       | more people. It's really quite strange how opaque most of these
       | processes are. How they are handled and documented is also quite
       | nuts.
        
         | lozenge wrote:
         | Strange? More like inevitable given the incentives involved.
        
       | kylecazar wrote:
       | Kind of demoralizing story (but a good read). Even a renowned
       | litigator with the right friends and plenty of money was only
       | able to secure (potentially partial) payment for the treatment?
       | The system doesn't even allow for damages?
       | 
       | Almost made me even more frustrated. I was hoping they'd have to
       | pay up big time, or that some legal precedent would be set in his
       | victory that would help millions in the future avoid this mess.
       | 
       | Also title could use a 'treatment' added to it.
        
       | lukev wrote:
       | Pretty much the same thing happened to my dad. He was diagnosed
       | with a rare type of blood cancer. The insurance company denied
       | monoclonal antibodies (as recommended by his oncologist) and
       | would only pay for a complete bone marrow transplant, which would
       | have been highly traumatic at his age. All based on a "standard
       | of care" that at that point was 15 years old... and which was
       | originally written by a committee chaired by my dad's oncologist
       | (who presumably knows something about the best way to treat this
       | condition in 2022.)
       | 
       | They didn't reverse the decision until we got a lawyer who knew
       | the ins and outs of the appeals process. Thankfully, we were able
       | to work through that fast enough for treatment to be effective...
       | there's no way we could have paid out of pocket.
       | 
       | The ability of an insurance company to unilaterally deny
       | treatment, or determine what type of treatment a patient
       | receives, is obscene and should be categorically illegal. There
       | is no instance in which a medical bureaucrat should should be
       | able to, sight-unseen, overrule a patient's own doctor.
       | 
       | It's so frustrating.
        
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       (page generated 2023-11-07 23:01 UTC)