Question:
How much clout does the State Ins. Board Have?

I opted to send my 3rd denial appeal for Plastic Surgery to the TN State Ins. BOard. I was denied twice by John Deere, on Platic Surgery, although they approved my WLS w/no problem. I received a letter yesterday which stated they recommended that John Deere reconsider and approve almost all of my PS. I wonder how much clout they have and what can I hope for? Any thoughts? Thanks, Patti Meadows/ e-mail: [email protected]    — peppermintp (posted on October 12, 2003)

October 12, 2003
Patti, it depends on what type of policy you have. If it is an actual insurance policy (such as Blue Cross or Aetna), the can carry more clout. But if your coverage is self-insured by John Deere, they carry none. Self insured coverage is regulated by the employer and they would have the final say. Read your insurance book and determine this. If it is self-insured, you might write to your Human Resources department.
   — lharbison