Coverage For LapBand Leak?

My insurance company GHI had denied coverage for my surgery in 2005 through Intracorp (for the City of New York).  I appealed twice and & then finally appealed to the New York State Department of Insurance who overturned the denial. I had surgery 1/23/06.  I have been having a loss of restriction and now my doctor suspects a leak in  my tubing or the port.  He has me scheduled for a test at the hospital on Monday to see where the leak is. I could not have done anything myself to cause a leak. As I understand it either my band is defective or my doctor may have punctured when he gave me a fill.  Am I responsible for a defective band or even if my doctor made a small hole in the tubing? Does my insurance have to cover these costs it they paid for the surgery?

They may give you a hard time, and you may have to go to the insurance comish agian. But you should get coverage eventually, if you are denied I would point out in your appeal the procedure was approved by the comish, and that you would hate to have to go all the way agian.

Thanks Jack, I'll post again if I hear any news.