While families take out insurance policies to ensure that financial assistance is available in the event that a medical event occurs, it is unfortunate when an insurance company denies a claim using logic that is self-serving than anything else.
One such case of this recently occurred with Eau Claire, WI resident Jeff Rogers and his three-year-old son Collin, who was born with a condition called congenital nevi – which leads to the development of moles on his skin that can be up to four inches in diameter – and neurocutaneous melanosis – or lesions on the brain.
In addition to receiving speech therapy to correct impairments that were caused his conditions, Collin must also wear special clothing with sunblock that prevents the suns radiation from coming in contact with his moles and leading to a reaction. These pieces of clothing can cost up to $80 each, resulting in substantial costs for the Rogers.
"Seven of [the moles] have been removed and none of them have been cancerous. That's the good thing but the more that he's outside out in the sun… the sun's radiation could cause these to become cancerous," said Rogers, according to ABC’s Eau Claire affiliate WQOW.
To make matters worse, Rogers said that while the doctors had specifically recommended the clothing as a way to control Collin’s conditions, his insurance company has refused to pay for the costs as part of the family’s policy. He added that dealing with his insurance company became increasingly difficult as he tried to contact them in order to plead his case.
"You get someone and [they say] 'Hold please, hold please.' You finally get a hold of somebody and they're like, 'Sir, we're going to have to check into it' and it's months later before you hear anything back from them and you didn't pay your bills and now you have to go into collections because they're trying to straighten it out, but in the meantime, they want their money," he said.
Currently, half of the income earned by Rogers and his wife go towards care for Colin.
Many times, situations like this may constitute an insurance company acting in “bad faith” and not properly obeying the provisions of their agreement with a customer in order to avoid paying out a claim. If you feel that an insurance company is unfairly denying your claim, call Sokolove Law today to learn more about pursuing a bad faith lawsuit. Call us today at (800)-561-7154.