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Holding High-Profile Insurers Accountable

On Behalf of | Sep 10, 2020 | Firm News

Many legal disputes surround the classic “David vs. Goliath” dynamic.

An influential and well-known company boasting a significant market share combined with vast legal and financial resources does not hesitate to go after individuals who are nowhere near as powerful. The country’s health insurance companies are as Goliath as it gets, and they often try to impose unreasonable decisions on families and individuals.

This recently happened with a Pennsylvania family. A Blue Cross company tried to tell the family that Blue Cross would not pay for treatment that their twelve-year-old daughter had received at the Children’s Hospital of Philadelphia (CHOP). Blue Cross didn’t tell the family this until after most of the treatment had already been provided. The treatment had been ordered and provided by some of the world’s leading experts down at CHOP.

Thankfully, the treatment worked. And no reasonable person would second-guess the medical decisions of these brilliant doctors. That did not stop Blue Cross, though, and the family, which thought they had good health insurance, was left staring at over $200,000 in medical bills.

Greg Heller of Young Ricchiuti Caldwell & Heller, LLC, agreed to take on this fight pro bono. He sent more than a dozen letters, and many thousands of pages of records and documents, to Blue Cross. At times it seemed as if the entire appeal process was designed to confuse and mislead. Thankfully for the family, Blue Cross eventually relented and agreed to pay for the life-changing medical treatments.

Finding a resolution was not about money as the family did not pay a dime in legal costs. The larger issue was about doing the right thing. Our firm had the skills and knowledge to succeed and Blue Cross knew they were in for a fair fight this time. Seeing a huge burden lifted off people facing six figures in medical debt was payment enough.

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