Most people believe that when they have a medical emergency, their insurance will cover the cost of treatment. Sadly, many insurance providers seem to put profits ahead of patient care. Insurance claims don’t always cover the treatments that Texas families need. This is what one out-of-state woman says happened to her when her insurance company refused to cover an MRI her doctor ordered. She has decided to take the company to court over her resulting paralysis.
The woman, who used to work as a school nurse, was helping an elderly relative exit the shower when she fell and hurt her back. She tried therapeutic yoga and nonprescription pain medication as recommended by her primary care doctor, but her pain worsened. Her doctor ordered an MRI about 2 1/2 months after she got hurt, but her insurance refused to cover the test, saying it wasn’t medically necessary. Her physician personally spoke with the woman’s insurance company, but it wouldn’t approve the MRI until the doctor ordered it a second time.
She had her MRI over five months after she was initially hurt. It revealed a mass around three of her vertebrae near her spinal cord. The mass was removed, but it caused irreversible damage that left the woman permanently paralyzed. She decided to file a civil claim against her insurance company and hopes that she can receive damages to compensate her for all that she has been through.
It can be difficult to get an insurance company to recognize when it needs to take care of clients, and the results can be devastating, just like in this woman’s case. Families here in Texas dealing with denied insurance claims may want to involve an attorney with experience in this area of the law. It is important to hold insurance companies accountable for their actions and/or inaction.