Medical insurance is a contract. Buying medical insurance does not mean that the insurance company is compelled to pay for any treatment that you desire. Insurance companies enforce medical contracts as they interpret them. I do not know the facts of this case nor the intracies of medical insurance law to indicate if the insurance company was right to deny coverage.
I am sorry about this poor girl’s death but I do not blame the insurance company even if the insurance loses in a lawsuit. If insurance companies are forced to pay for any treatment demanded, medical insurance rates will rise even higher. The insurance company did not deny treatment. They denied coverage.
“The insurance company did not deny treatment. They denied coverage.”
In that one must either have a guarantee from the insurance company to pay for a transplant, or one must have several hundred thousand dollars, sometimes closing in on the better part of a million dollars, in cash to obtain treatment, I think that this is a distinction without a difference. They damned her to death. They deserve like treatment.
“Buying medical insurance does not mean that the insurance company is compelled to pay for any treatment that you desire.”
That’s true. Years ago, I had a crazy aunt who kept asking for doctors to treat her for cancer, though multiple x-rays and such over a period of 20 years showed that she had no cancer. Until she got cancer. We always figured it was 20 years’ of x-rays that did her in.
Certainly, no insurer would have been obligated to pay for cancer treatment while she was cancer-free.
But if you’re looking for something that is part of the ordinary standard of care, they must pay for it.
In that the girl’s doctors approved of the operation, and the folks who hand out the organs approved of her receiving the operation, there is a strong presumption that the operation was part of the ordinary standard of care.
Organs aren’t handed out to “hopeless cases.” It’s sort of a tough situation for folks on the waiting list. You hope that you get sick enough to be the next person for a suitable organ, but then don’t get too sick while you’re waiting (morbidly) for someone to die who will have a suitable organ for you. Because, if you get too sick, then the organ folks will give the organ to the next person on the list who can use it.
I suspect that Mr. Geragos took up this case because he needs easy money.
sitetest
“The insurance company did not deny treatment. They denied coverage.”
That’s a good one! LOL!
And they will always decide in their own favor. They are a government protected racket that make their living screwing people. IMHO they are the only entity lower that a slip and fall lawyer.