October 28, 2009

The Health Insurance Law Most Lawyers Don’t Know

A father sits in my office. He is a large man. He earns a decent living for his family as an electrician. He doesn’t seem to be the kind of man who weeps openly but today the tears flow freely. This is our initial interview. He gathers himself and begins to tell me his problem. His daughter has a serious medical issue necessitating surgery and ongoing care. Her physicians agree that this course is medically necessary. Nevertheless, his health insurance has denied the claim.

His health insurance is through his employer. Blue Cross Blue Shield has refused to pay for the surgery stating that it is not covered under the policy. He tells me that the doctors will require $50,000 up front to perform the surgery and that the total expense will be substantially more than that. He tearfully explains that he does not have anything close to the up-front amount. If he sold everything he owns and borrowed from friends he might have half of it. Read more...