Question:
In appealing an exclusion, has anyone ever heard of using violation of ADA ?

I am diabetic along with my morbid obesity and just found out my insurance excludes wls. I am looking at all avenues and wonder if this would be covered by the American with Disabilities Act which prohibits discrimination in the provision of benefits. Since this is under my health benefits would this work as a defense. If anyone has had any experience with this or suggestions on resources I would appreciate the help.    — cheryl R. (posted on August 27, 2000)

August 27, 2000
The Americans with Disabilities Act covers Employment, Transportation, and accessibility to public places. There is no application for provision of coverage for insurance. Insurance companies can, as far as the feds are concerned exclude anything they want. Only at the state level is legislation being passed that requires the inclusion of this medical treatment. I would suggest that you appeal through your state insurance board for 'bad faith', meaning the insurance company is not providing a treatment they said they would in the contract and look for loop holes. One that comes to mind is 'treatment for obesity' is different than 'treatment for morbid obesity'. Consult a personal injury attorney and be prepared to pay them an hourly rate if necessary. Good luck! Fondly,
   — merri B.