4 ms·
I am surprised that this hasn't started a class action lawsuit yet. The insurer through delays is causing harm. I'm guessing it's a contract thing though. On
by sjg007 7y ago
I am surprised that this hasn't started a class action lawsuit yet. The insurer through delays is causing harm. I'm guessing it's a contract thing though. One thing to do is if your plan is regulated by the state then immediately start an appeal with your state's department of insurance. There are also advocates at some hospitals and insurance companies. The other thing to do is go to a very large academic cancer center... presumably a tier 1 research hospital. Outcomes are also better. They usually have staff that know their way through each insurance company and PBM.
- erentz 7y agoBecause most people get their insurance through their employer they are usually self funded plans covered by ERISA. Your only recourse is that provided under ERISA which limits damages to the cost you paid for a treatment that wasn’t covered but should’ve been. It’s abhorrent. Congress in making this law 50ish years ago essentially took away people’s right to sue and get justice in this instance. It was a huge gift to insurance companies and it needs to be fixed but people only learn about it when they are exposed to it. I wish there were politicians willing to step up and change this particular law. When people talk about tort reform I think they’re really misunderstanding who such reforms benefit, as in this case it only serves the large companies and allows them to act in bad faith without proper repercussions.