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Why do insurers so often refuse coverage for rare cancers?

On Behalf of | Dec 17, 2019 | Denied Insurance Claims

Insurance companies routinely state that they refuse to pay for costs linked with patients’ rare cancers because recommended treatments are experimental and unproven.

A noted cancer expert and legions of her peers in the medical industry reject that assertion.

In fact, university oncologist, professor and writer Barbara Goff flatly dismisses it in the “Patients Die While Docs On Hold” article she recently penned for a national publication. Her piece is a frontal slam on an industry where she states “unknowledgeable people” routinely overrule informed medical opinion simply because their employers “don’t want to cover” the costs necessary to keep patients alive.

Goff spares no words in casting an industry that is so often a core nemesis for doctors in harsh terms. She contrasts her decades of singular experience as an expert in cancer identification and life-saving care to insurance company employees “who know nothing about the cancers that I take care of.”

In doing so, she underscores the massive amount of time she and her peers spend dealing with uniformed third parties in efforts to explain treatment rationales and secure coverage approvals.

And she laments the many instances when a recommendation she knows from unparalleled personal experience is rejected by an anonymous party with no medical experience.

As noted in a recent media piece spotlighting insurers’ treatment denials, the frustration routinely suffered by Goff and legions of other doctors across the country is far from merely being academic. That article stresses that company reps’ vacillations, bureaucratic wavering and denials “are literally killing patients under time-sensitive conditions.”

Sometimes insurers’ actions cross a plateau separating questionable responses from bad-faith conduct. Individuals s with questions or concerns about delayed or denied insurance coverage can reach out for guidance and diligent representation to proven attorneys at an established pro-policyholder insurance law firm.