Posted on 02/28/2025 9:20:18 AM PST by Red Badger
OGDEN, Utah (KUTV) — An Ogden man has been denied a lifesaving liver transplant from his brother by his insurance company.
Nathan Kirkland discovered he had bile duct cancer in April of 2024 while his wife was pregnant with their second child.
"Our cancer journey started in Utah. I was told I might not see my daughter born in August,” he said.
The news devastated his family as they tried to figure out what to do next.
"Should we just be taking the trips that we always talked about, should we be trying to make the most out of every minute. We made some tough decisions at the time and decided we weren't going to accept that outlook,” Kirkland said.
He underwent numerous treatments for cholangiocarcinoma — bile duct cancer — but has reached his limit on chemotherapy. The next option is getting a new liver.
For many, a liver transplant can be a cure for hilar cholangiocarcinoma, but there is a risk that the cancer will recur after a liver transplant.
He had already beaten the odds by surviving way longer than doctors expected, and now could be on his way to a cure: a life-saving liver transplant from his brother.
There was one battle he wasn’t expecting.
"I've been battling insurance every step of the way. So, this latest battle is insurance trying to make a decision about my life for me. Through this process we learned it takes a lot of time with insurance, and we just don't have time anymore,” Kirkland said.
He said the insurance had been approving them all the way up until they got to the transplant, which had already been scheduled for February 14.
Since the denial letter on February 6, 2025, they’ve been reaching out to Anthem Blue Cross Blue Shield for answers.
"It's just non answers. We asked for the evidence of why they denied us and we're not getting those documents, we're not getting those answers,” he said.
They shared their story on Facebook, where it has been gaining traction.
Kirkland and his family are on their way to Pittsburg for the transplant Friday. They are stilling waiting to find out what insurance will cover.
KUTV reached out to Anthem Blue Cross Blue Shield, and they said this is a matter of HIPAA authorization, something we are coordinating with the family.
Insurance companies cannot unilaterally change terms and conditions. They only change if you agree to them. Do you have an example of a lie?
The roadblocks and obstacles placed by one insurance company for trying to collect a life insurance policy that had been purchased 3 years previous to the subject’s death is ONE of the reasons I loathe insurance companies.
The theft of my truck, and the insurance company’s refusal to return the truck in serviceable condition or pay me its replacement value (specified in the contract) is strike 2
The sudden decision by another life insurance company to raise its rates by nearly 700% on an associate’s 60th birthday is another example.
You can defend them all you like, but I am far from alone in my complete disdain for the crooked practices of a LARGE number of underwriting companies. They have built their reputations on stories like these.
No insurance company that I know performs surgeries.
you have zero idea just how regulated the health insurances companys are. state/feds
I am well aware of the ludicrous levels of regulation. The reasons I gave for my dislike are among those that caused the gov’t to step so far into the regulation game.
IF they were honest from the beginning, the regulations would not have been needed, and yet here we are, with that specific argument only bolstering my view.
Necessary evil, nothing more or less. Ethical leadership in the companies would have been a better way, though.
A sudden increase at age 60. 60 is a typical age for rates to go up and it was in his policy.
Road blocks and obstacles. But you got paid. Are they supposed to take everyone’s word like the government?
OH believe me, the regulations are completely out of control especially at the state level, having been in the health insurance claims payment level for 30yrs I have seen stupid rule and regulations.
Most if not all health plans have a transplant coordination. that work with the transplant centers around the country. something didn’t add up in the story. may be incomplete documentation sent to the plan.
I don’t think his brother is going to give up part of his liver to a stranger so the whole “someone more deserving will get this liver” is nonsense in this case.
My point was more to the standard practice of withholding transplant organs because of all sorts of medical reasons. The health of the recipient is always first consideration, but there are many hoops that have to be gone through typically. All of the organs are tested for their ability to function, including lungs, digestive tract, brain, dental, etc., after which you are assigned a MELD score. A high score determines the place on the UNOS Transplant list, and an assessment of financial ability to pay for it (insurance, out of pocket, etc.) It is admirable that the brother offered a partial liver, but there are many more considerations than that. Insurance was made to be the villain here, and your point is well taken. However, the reporter did not offer a full description of the process and made the story about insurance, which is was not. I am hopeful that it worked out, but what you see on TV is not really how it works. It is presented as a near 100% certainty of saving ones life, but it is not that simple.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.