Question:
Anyone have this exclusion? Can it be fought?

I just recieved my first denial from my insurance company. The exclusion reads " No benefits shall be payable under the Plan for any charges resulting from: -Any treatment of obesity or weight reduction whether surgical or medical and/or complications arising from such treatment." I was told by a few people they thought this was airtight ... any suggestions? Also I am going to appeal and need help with a letter, any help would be greatly appreciated.    — Juanita N. (posted on September 9, 2003)

September 9, 2003
What insurance company do you have?
   — SMG I.

September 9, 2003

   — Juanita N.

September 9, 2003
others on this site have said to stress "morbid" obesity, not just obesity. they are 2 different things. That exclusion doesn't say anything about morbid obesity. Make sure your doctors letters say morbid and not just obesity. They have examples of appeal letters in the library. Also there are lawyers such as Walter Lindstrom at Obesity law and advocacy center that might help.
   — jaetex

September 9, 2003
I had a similar exclusion to my policy with BC/Bs and they would NOT budge. I even got the lawyer to help me but no matter how I worded the obese versuses morbid etc.-when they said no by golly they meant it. Nothing would help me. If something helps you-let me know. God Bless you and good luck.
   — CARLA C.

September 9, 2003
I contacted Mr. Lindstrom via his website just to see what he thinks. I appreciate those who posted, I am crossing my fingers, eyes and toes and hopefully I will be approved before too long.
   — Juanita N.

Click Here to Return