They are nuts
Opti and Henry,
Not to be a downer but they will try anything they can to not pay.
Opti you are correct regarding emergency. It still doesn't matter. Just went to my 2 level in person and they fought me all the way. The Doc on the panel couldnt believe his eyes when I walked in. then was in total disbelief when they found out I had the neck done as well 6 Months prior. He actually nodded his head and smiled in approval.
I have and had all documentation and 3 letters from the surgeon. With the last one stating exactly that Emergency along with 8 exhibits all bound nicely for each member. Their jaws dropped when I pulled all the stuff out. Cauda Equina Syndrome is a clear emergency under any curcumstance. Now I am not sure as to the outcome yet since they have 5 days to finalize. What I can say is you need to use the handbook against them. They will find any small thing to wriggle out of paying. I have read this book cover to cover and flagged everything. I found some interesting things of which would be a no brainer to beat them with their own book. Wont post it here to broadcast but I know 100% if they deny me again I will win with the Insurance commission and plan on taking them to task.
For me its sport. All upside since I could really care less about the money. Yes I would like to get it back but Im having fun with this!!!
More to come. I hope you guys make out well too.
F
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Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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