Question:
What should I know about suing my insurance company for WLS?

I live in Oregon, and have ODS Health. I would like information from "anyone" who's filed a lawsuit against their insurance carrier or ODS for WLS coverage. How did you find an attorney? How much did it cost you? How long it took for a decision after you filed? What were the results of the lawsuit? Did you seek any compensation for damages, attorney fees, etc.? ...any other helpful information you can offer.    — Wanda M. (posted on January 22, 2000)

January 22, 2000
go to Dr. Rutledges site at http://clos.net I believe he has info. on that site showing how to get a hold of attorneys who specialize in suing ins. co. in matters of obesity. also check out or call www.asbs.org.Hope this helps!
   — cristy P.

January 22, 2000
Have you gone through the appeals process yet? If you haven't, don't give up. I just went through this and was successful in turning the insurance companies decision around. Keep plugging at them.....I think several insurance company's deny the first go round to weed out those who weren't serious in the first place. I spent some time writing my appeal letter but once it was submitted, it took less than a week to get my approval. I wish you all the best. Janet
   — Janet F.

January 22, 2000
Please get in touch with Linda T at [email protected]. She has gotten over 25 people approved on appeal - free of charge. Good Luck! Marjie Wassermann (Lansdale, PA)
   — Marjie W.

January 22, 2000
I don't know anything about litigating against insurance companies for denial of services, but I do know a bit about appeals and such. I was denied with one company last year, changed jobs/insurance, and was again denied in December of '99. I put together a 124 page appeal, complete with all doctor visit records as they came in, a complete picture history from birth to present, articles on effects of leaving morbid obesity untreated, and of course my own letters. I wrote letters to my legislators in state and national senate/house, the insurance company, and the state board of insurance. I copied everyone and their brother on it, and asked for testimonial letters from my online friends who'd known me for well over a year. They wrote on my behalf, and I sent them all to the insuance co, again copying everyone on it. I filed a complaint with the state insurance board, and one day after notifying my insurance company that I had done this, I received my approval. Keep in mind, I'm not one to make a fuss, but it is competely true that the squeaky wheel gets the grease. If you are dealing with an insurance company who balks at this, you must basically throw a gigantic temper tantrum until you get what you want. Keep it respectful and professional, but...well, throw a fit and make sure anyone having anything to do with your case knows about it. Make sure you have medical documentation to back up your case, then bombard them with all of it. I even got my mother and sister to write letters testifying as to what I've dealt with my entire life. One last word of advice; when writing to the insurance company, do it snail-mail, always date it, send it registered, and state exactly what you will do and when you will do it. Best to you.
   — Linda K.

January 22, 2000
I don't have your answer, but I may be asking for myself soon. I have ODS and have been denied (not medically necessary!!!). I am approaching my final appeal hearing on 2/1/00 with the help of Walter Lindstrom, the San Diego attorney who specializes in fighting for WLS surgery approval. Walter has had other denials from ODS and may pool several clients to minimize expense of suing ODS. You can reach him at obesitylaw.com. Feel free to call me at 245-3530. Tom Boyer Tigard, OR
   — Tom B.

January 23, 2000
Contact Walter Lindstom. I wish I had when I was denied. I self paid and it was worth it, but it sure would be nice to still have that 12,300.00 dollars.Good Luck!!
   — Donna D.