Question:
Has anyone beat a tough exclusion?

and related expenses, regardless of whether the initial surgery was covered under this certificate." I appealed and was denied. I argue before grievance/appeals committee 2/5/01. I tried to tell them it is not repeat but repair. That didn't work. They refused to give me more time to prepare for hearing(I had planned to hire Walter L., he needed 30 days) I plan to argue ADA discrimination against a disability, EEOC and SS recognize as such. NIH considers a disease. and use cancer as example. Since Morbid obesity is a lifelong diagnosis, we just get treatment not a cure. Like cancer goes into remission but not cured. They are punishing by withholding TX for return of disease symptoms, wouldn't withhold 2nd round of chemo if cancer returned. I cannot help that a mechanical breakdown occured and my surgery needs repair. If anyone has used walter or beat such a tough exclusion and can think of any other argument I can use please email me so I can write my speech ASAP. They lied when I bought the policy too. I had already had consult for revision and specifically asked using codes if it was covered, my docs office did too prior to mailing letter and med records. They told both of us yes if can proove med. nec. Said no contract exclusions or pre-existing clauses on policy. I am kicking myself for not getting name of person date time etc. Learning hard way. Thanks to anyone who can suggest something.    — Julie B. (posted on February 4, 2001)

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