Colleen Henderson’s Fight Against Insurance Denials: A Mother’s Story of Advocacy and Triumph
When Colleen Henderson’s 3-year-old daughter started complaining of pain while using the bathroom, she sought medical help. Doctors initially dismissed it as a urinary tract infection or constipation, common issues in young children who are potty training. However, when her health insurance refused to cover the cost of an ultrasound, Henderson took matters into her own hands and charged the $6,000 procedure to her credit card. What they discovered was shocking – a grapefruit-sized tumor in her toddler’s bladder.
This was in 2009, and the next five years were a constant battle for Henderson against her insurer, UnitedHealthcare. Despite multiple appeals to cover the specialists and treatments her daughter needed for her rare condition of inflammatory pseudotumor, the insurer continued to deny coverage. The family ended up accumulating over $1 million in medical debt, ultimately leading them to declare bankruptcy. Henderson firmly believes that if she hadn’t fought tirelessly for her daughter’s care, she might not be alive today.
The issue of insurance denials is becoming increasingly common, with surveys showing that very few Americans actually appeal these decisions. However, when escalated to government regulators, many of these denials are overturned. This has led to growing concerns among consumer advocates and policymakers about the practices of insurance companies. In response, a new proposal in the California Legislature, SB 363, aims to penalize insurers who repeatedly deny necessary care. The bill would require insurers to disclose denial rates and reasoning, as well as impose fines for wrongful denials.
While the measure would only cover a portion of insured Californians, it is seen as a bold attempt to rein in health insurer denials. If passed, it would require insurers to provide detailed data on denials and appeals, as well as report the outcomes of these appeals. Insurers whose denials are overturned more than half the time could face hefty fines. The goal is to hold insurers more accountable and ensure that patients receive the care they need.
The tragic incident involving the killing of UnitedHealthcare CEO Brian Thompson has further highlighted the public’s frustration with insurance company practices. While insurers argue that they are highly regulated and operate on low margins, the reality is that denial of care can have severe consequences for patients. The proposed bill in California is a step towards addressing these issues and ensuring that patients are not denied necessary treatments.
Overall, the fight against insurance denials is ongoing, with families like Colleen Henderson’s and Sandra Maturino’s facing significant challenges in getting the care they need for their loved ones. By advocating for reform and holding insurers accountable, lawmakers and advocates hope to improve the healthcare system and ensure that patients receive the care they deserve.
