Originally Posted by eliduc
This has nothing whatsoever to do with horses but I think it is worth passing along as it might be relevant to people over 40. The city of Tulare Calif. Is suing a Canadian insurance sompany for bad faith claim denial. A woman 19 years old had leukemia. She had a bone marrow transplant which is standard. The hospital asked for her permission to use two experimental drugs for the purpose of judging the effectiveness of the drugs. The cost of the drugs was $23,000. The entire bill was over $450,000. The insurance company is denying the entire claim on the basis of the use of the experimental drugs. The city which provides insurance for it's employees paid the hospital up front and is now suing the insurance company for bad faith. The moral of the story is that an insurance company can use the treatment of experimental drugs as an excuse to deny an entire claim.
True, the use of experimental treatments is not covered by most insurance companies. Here in Missouri we have a state law that requires us to pay for the doctor and hospital visits that go along with the drug that is experimental - in other words, the researchers or drug companies will pay for the drugs, and some of the lab tests or whatever is required, but the rest of the care must be covered by the insurance companies. Sounds like the Canadian company didn't have that requirement. It also sounds like they could knew the plan and could have educated their insured member ahead of time if they'd wanted to.... I hope this works out for the young lady!