Yes, you have been my insurance carrier for several years now. I pay out the nose so I can have decent insurance. I do not understand you in any way, shape or form. You so easily pay for some things and fight, deny, fight, deny other things all under the guise that my employer is asking you to do this. I will not take the most recent coverage denial lying down.
We were fitted for a wheelchair back in September. Who WANTS their child to need one (unless they have Munch.hausen by Proxy)? It was a life altering, traumatic experience to realize that my child will need one and come to the decision to get fitted. I find it truly crappy that you send us the paperwork for denial two weeks before we were supposed to get the chair. It is crappier that you sent it addressed to my child. She is only six and does not understand the ins and outs of the insurance BS you put us through (although she might be able to make sense of your nonsense in her world). It is the crappiest that it was right before Christmas.
What part of Spastic Diplegic Cerebral Palsy do you not understand? Yes, she walks. She doesn't walk far or well for long periods of time. We can't make it through the grocery story, let alone Walmarx, the mall or downtown parking to get to dr. appointments with out her needing to be carried or ride (in her stroller which if for babies, she has NO independence in that). You have paid for her Mac.laren Major with insert, her multiple DAFOs, her weekly therapies and numerous dr. appointments.
Yet, you deny her wheelchair for ridiculous reasons. Quotes from the letter:
=The individual does not have a disease process or injury for which weight-bearing and/or ambulation is contraindicated.
=The individual does not have a disease process or injury that precludes use of the lower extremities
= A seat width and/or depth of 14 inches or less is not recommended
Again, what part of Spastic Diplegic Cerebral Palsy is not understood??? As far as the smaller seat width---- she is a small child! DUH! DUH! DUH! They also do not want to give us a light weight wheelchair cause the caregiver can push a standard chair. I can, but she is, once again, a small child and we are hoping she can gain independence by maneuvering herself.
As I said before, I will NOT take this lying down. You ruined my Christmas and have started off my New Year on a sour note. I guess filing multiple back injury claims will help? I am filing every appeal you give me, already at the third level. I have gotten the CEO of my hospital involved (yes, I work at a hospital that has multiple people disbelieving this as well). A basic pediatric wheelchair is NOT a luxury for us, it is a necessity.
Ci.gna Insurance, you suck! F*@k you very much for you inattention to this matter.
7 years ago