I don’t do this often, but I’m asking for help from you guys. I want you to read this post and tweet it and re-tweet it because it’s a story that needs to be told.
We’ve all had our battles with insurance companies, right? I had a pretty massive one with mine when I had Miss G and accidentally underpaid my monthly bill by $7.00 and they expected me to foot the entire bill. I kicked and I screamed and I got my way. They paid. I have a friend, however, who is not having the same luck. And the situation she faced was far more serious than the simple birth of a child.
Her name is Jennifer West Jablon and she only wanted one thing.
She wanted a chance to live.
Jennifer recently underwent a double mastectomy voluntarily because she had the BRCA1 gene. She’s young and she’s a single mom. She also has a family history of breast cancer. Her mother is one of five daughters, three of whom were diagnosed with breast cancer and one of the sisters died from it. Being a responsible mom, Jennifer went and had the test to find out if she was at risk. The news was not good. Her doctors told her she had an 85% chance of developing breast cancer by the time she was 40 and a 99% chance of developing it later in life. Her doctors advised her that the best possible route was to undergo a voluntary double mastectomy and that is exactly what she did. Because she is a single mother.
And she wants to live to raise her son.
Jennifer is also responsible financially. She took out two disability policies to pay for her five week recovery. (Editorial note: When I first posted this, I neglected to mention she took out the policy when she started her job over one year ago, not right before the surgery. At that time, she did not have her surgery planned. For anyone who was wondering about this, please see her note in the comment section.) The first company, Mutual of Omaha, was to pay 60% of her salary. The second, Colonial Life, was to pay a per diem to make up the difference. She paid her premiums. She went into this surgery knowing she was doing the best thing for her and her son and willingly put herself through a tremendous amount of pain and a ton of reconstructive surgery for one thing.
She wants to live.
However, after paying her premiums and doing all the right things and getting the recommendations from the doctors the insurance companies now do not want to pay what they rightfully owe her. Jennifer has tried to reason with them, even sending letters to them explaining the situation and how she certainly would have cost them much more money down the road with radiation, chemotherapy and everything else that goes with a cancer diagnosis.
It’s also important to note that her primary health insurance carrier deemed this medically necessary.
Her emails to the companies that denied her were Scientific:
“I made this decision to have a Prophylactic Mastectomy based on a recommendation by my Surgical Breast Oncologist, Dr. David Euhus, MD, at UT Southwestern Medical Center who has received the following accolades for his work with breast cancer: Marilyn R. Corrigan Distinguished Chair in Breast Cancer Surgery (2003) and The George & Carol Poston Professorship in Breast Cancer Research (1999). I also attended several seminars on genetic breast cancer screening and treatment organized by FORCE (Facing our Risk Cancer Empowerment).”
…and Emotional:
“I am a single mom of a 7 year old boy so it is my responsibility to raise him as well as provide for his needs. In having the surgery, I feel like I am prolonging my lifespan, and to provide for his needs I took out two disability policies so that I could pay my bills.
I proactively took a step that could ultimately save my life and keep me from having to go through chemotherapy and/or radiation. It was neither an easy decision to make nor an easy procedure to endure. I was in surgery 12.5 hours of surgery followed by 12 hours in ICU and 4 more days in the hospital a total of 5 days inpatient care.”
…and finally POWERFUL:
“The costs to all parties involved would be more significant had I waited to develop cancer and then seek treatment. The cost for me and my son could have been my life.”
Jennifer did the right thing. She saved her life so she can be present for her son and help him to grow in to a strong and capable young man. And now, the insurance companies want to bicker with her over what is a small amount of money to them given the premiums they collect on a daily basis from trusting customers who expect them to honor their commitments when they most need it.
The only hope Jennifer has of recovering her money is to make as much noise as possible which is where you come in. If you would tweet or stumble this, you will be my personal hero. Until we all stand up for each other, the big insurance companies like Mutual of Omaha and Colonial Life will still keep taking advantage of the weakest among us when we really need it. The only hope she has right now to get the money they rightfully owe her is to make a bunch of noise.
{ 46 comments… read them below or add one }
Holy shit..sorry – I had to curse on this one. This totally effing sux – I will tweet it and repost it on Facebook!
Krystals last blog post..Spin Cycle: Routines
Do you know anyone in the news field? Stuff like Jennifer’s struggle is exactly what they love and coverage over Jennifer’s struggle would make the insurance companies pay attention!
Sprite’s Keepers last blog post..Spin Cycle: The Same Old Same Old
It’s on my Facebook page!
Jans last blog post..Asian Lettuce Wraps
Wow, this is really sad. I do not understand why insurance companies deny people life saving procedures. What gives them the right to play God?
Khadras last blog post..the ramblings of a bored housewife
TSM, are you saying that the disability income insurance is not paying, or the actual medical procedure bills are being denied, or both? I can say that for disability insurance, they will do a pre-ex look back. Some look back for a diagnosis within 3 months of the loss of income, and some 6 or 12 months. Most of us think about buying life insurance first and foremost, but we usually need disability insurance even more so to protect our ability to pay bills. If it is through an employer, we need to sign up for it when first eligible or during open enrollment. If it is through an individual policy or a group policy, there are usually pre-ex limitations.
If it is the medical bills not being paid, is her insurance individual or via an employer’s policy? If via employer perhaps the broker and employer can help. If it is self-insured by the employer they (the employer and not the insurance comany) pay the claims and have the final say.
I am so sorry that she is having to stress about the bills and I commend her for her very difficult decision.
Michele renees last blog post..I Lucked Out in the Sister-In-Law Dept. and I am Late to the Jewelry-Making Party
I hope she gets the money from them. I’ll tweet it and put it on my facebook page. I hope she can take this to a news bureau.
Micheles last blog post..Avocado Egg Rolls with Cilantro Dipping Sauce – Friday Foodie
In Detroit, we have Ruth to the Rescue on one of our news stations. You probably have something like that, too. If they agreed to insure her, even with the diagnosis, I’d say they are on the hook.
Middle-Aged-Womans last blog post..I’m Getting Very Good at Typing Ulysses S. Grant
I would def. contact the news in your area or her area (if its not the same) I will be tweeting about this and with your permission I will link to your site tomorrow in my post!
Good Luck Jennifer!!!
Domestic Extraordinaires last blog post..Preparing for BlogHer
If I’m reading this correctly, Jennifer’s medical expenses were paid by her primary insurance company and what is at issue are the temporary disability payments.
If that’s the case, Jennifer attempted to use disability insurance in a way it was not intended. That’s to say that one can’t buy a policy knowing full well that they will use it to for a surgery that’s been planned for a pre-existing condition. The majority of policies state this very clearly.
“She took out two disability policies to pay for her five week recovery. The first company, Mutual of Omaha, was to pay 60% of her salary. The second, Colonial Life, was to pay a per diem to make up the difference.”
I feel for Jennifer’s situation, but the insurance companies are right in this case. You can’t purchase a policy for a pre-planned disability. If that was the case, many people would buy policies the month before, pay the premium, and then cancel when they went back to work.
Janes last blog post..When I said you were one of my favorites, I meant it in that Hollywood air-kiss on the cheek kind of way…
As a breast cancer surgeon, and Founder and Director of the Breast Health & Healing Foundation, I am appalled by the horror of this story. The insurance companies have us all boxed in, with no way out. We need a public health plan that will allow citizens to participate in the design of coverage and benefits. Please re-tweet that!
In the meantime, I wish Jennifer and her son all the best.
Take a peek at my blogs for useful information on ways to PREVENT breast cancer.
Many kind regards,
Dr. Ruddy
breasthealthandhealing.org
Hey everyone, TSM here…just to clear a few things up, it’s her disability that won’t pay, not her primary. Also, she is protected under something called the Genetic Information and Nondiscrimination Act of 2008, sect 13.
Most of all, I totally appreciate the positive responses and viral exposure you guys are giving this matter!!! Thanks so much!
As I’ve said in my blog posts: There’s a reason why, in every major city, there’s a large building owned by an insurance company.
The Dental Mavens last blog post..Not Just Another Fem-Bot. This Girls Got Skilz!
TSM, the act you cited still doesn’t give Jennifer, or anyone, the right to buy a disability policy to cover a pre-planned surgery.
I’m not trying to be negative, but those are the facts of insurance, and they’re clearly spelled out in every disability policy I’ve ever seen.
Our health care system is deplorable, and I’ve witnessed it up close and personal in the last few months, and I know what it’s like to give up wages and have no backup. There should be a better way, definitely. . .but it doesn’t take away from the fact that your friend tried to get her wages covered by purchasing disability for a specific, pre-planned event — and anyone who has ever bought disability insurance knows (or should) that this can’t be done.
Janes last blog post..When I said you were one of my favorites, I meant it in that Hollywood air-kiss on the cheek kind of way…
I have to admit, I also wondered about how the disability insurance was being used. But, if she is indeed protecteded by that law that you mentioned then she should get in contact with your state’s insurance commissioner. She should also tell Mutual of Omaha & Colonial Life that she will be filing a complaint with the commissioner as well.
I’ve had to go that route myself. It’s unpleasant, but it seems to get a response.
Best of luck to her for a full recovery & long life with her son.
Jennifer here the subject of the blog TSM was so generous to write about. I took out my disability policy when I signed up for benefits with my company. I have done that with every job I’ve ever had. I decided to have the surgery later. I didn’t take out the policy with the intent that I would have the surgery. I had the surgery thinking my wages would be covered by the policies that I had in place. Thank you for all your support and most of all to TSM for making my story public.
I just wonder which insurance company Jane works for. I love the letters that they always send asking for more information before they pay a claim. Delay, delay, delay, and then don’t pay. That seems to be the business model. Too bad AIG didn’t stick to that. It would have saved us all a fortune.
Don’t get me started regarding the condecending attitude of insurance companies & those individuals they employ.
I sincerely hope it all works out for Jennifer.
Reinventing Dads last blog post..Give me the "Dumbing it Down" version
While I don’t know the intricacies and legalities of the insurance industry, I DO know a good friend when I see one. TSM, YOU, my dear, are a wonderful advocate for Jennifer, using your voice to make a difference in her life, and perhaps in the lives of others.
I lost my mother to breast cancer when I was in grade school; she lost her mother to cancer when she was an infant. My sister is a 11+ year survivor
. I hate cancer…and almost as much as that, I hate witnessing an industry make decisions that cost everyone more in the long run.
Sometimes, with a life
.
Jennifer, i hope you see this! You should contact a legal advocacy organization that specializes in working with people with disabilities like this one: http://www.advocacyinc.org/index.cfm
They’re based in Austin, but I think they may handle statewide issues. I work for a similar org in Los Angeles (www.mhas-la.org).
Not sure if you remember me, but I’m Sherrin (Roberts then Rieder now Frances)’s sister, Nicole. Good luck! I hope you kick their asses!
Ugh. That’s really terrible. I hope she gets the exposure she needs to shame them into holding up their end of the bargain.
Keelys last blog post..Dear So and So
It’s on my facebook.My best wishes to your friend for her recovery and getting her insurance to cover their obligations. Battling with insurance companies to pay for things they should can take determination and stamina and I’m sure some publicity won’t hurt either.
Insurance company problems can seem insurmountable but it’s fortunate Jennifer had the genetic testing readily available and was able to have her medical needs met with prophylactic surgery.
We should all be careful assuming that national/socialized or government run health care would cover matters like these in a timely fashion. A quick Google of the subject in Europe seems to say otherwise.
the mayors last blog post..Just Relax!
I think the Texas Department of Insurance can put you in touch with someone who might help you. Look them up in a phone book.
You are a wonderful friend honey.
Cancer is a beast and in many instances the insurance makes it almost more unbearable.
Blessings, love and many prayers for your friend!! I stumbled this and will tweet it and share it in Google Reader.
I have no advice but, it looks like there’s some great advice being given up there.
Good luck and I hope that you keep us updated.
Very thoughtful of you TSM, to bring this to light. I don’t Tweet or even Facebook anymore – but I certainly send caring thoughts to Jennifer and the fervent hope that the insurance companies get their shit together!!!
Dana’s Brains last blog post..25 and counting
A similar thing happened to a friend of mine. The difference is she has a permanent disability and has paid her disability premiums for years (like more than 10 because she knew with her illness that the day would come that she would no longer be able to work) and now they refuse to give her disability payments. She even qualifies for Social Security (which is extremely hard to do). Insurance companies think that they can do whatever they want. They suck.
I Stumbled it, I Facebooked it, I shared it on Google Reader and I am about to Tweet it.
I’m sorry for your friend.
Shellis last blog post..Happy Birthday, Belley Bean!
I hope the insurance co. does the right thing.
I know people think I’m an idiot (and they’re probably right though not for this reason) but I won’t buy life insurance or any other “optional” coverage. Do you think insurance companies are in the business of handing out million dollar checks? If you die, they will find some way to get out of paying you. I live in Southern Cal where fires are a way of life. Every time they happen, the insurance companies stop paying the claims, saying they ran out of money. Yet, be one minute late on a premium and they’ll cut you faster than a meat slicer. Insurance companies = legalized extortion. I’m going to Tweet it right now.
Steely Dads last blog post..To Fart or Not to Fart?
Oh, I’m so late to this! Well, if it helps, I’ll certainly re-tweet and facebook. As someone who lost my mom to breast cancer, this hits a very personal nerve.
PAPAs last blog post..Post-it Notes Go Viral!
I’m not an angry person but when it comes to dealing with my insurance company I am livid. They bring out the absolute worst in me. I am so ready for single payer health insurance like so many countries in Europe. This whole medical business is ridiculous, beyond ridiculous.
I feel really bad for your friend. People just shouldn’t have to deal with this kind of stuff, ever!
The day we start valuing preventive care in this country will be a much better day. Until then we’ll continue to get sick and go bankrupt.
damariss last blog post..daily, daily, daily stuffs
Her best argument is her last one, her choice to have surgery saved the insurance companies money in the long run had she needed treatment for breast cancer. These companies are all about the bottom line. Horrible.
I thank God every single day that I live in Canada where immediate, free care is accessible to everyone. I’ll retweet.
Sashas last blog post..harry potter and the half-blood prince
TSM I will facebook this and tweet about it. Nobody should have to deal with insurance companies in this way. And people wonder why National Health Care is getting a second look, when this is the system we have to deal with, it starts looking like a viable option.
Kats last blog post..Rockin Out
Off to facebook and tweet…this is disgusting and I am horrified that the insurance company would do this. They need to pay!
Petra aka The Wise (Young) Mommys last blog post..He Blogs, She Blogs: Ladies Night!
This is kind of on the outrageous side. I’m appalled by the actions of the isurance companies. When you purchase disability policies, all that should be turned in are the forms neccessary to collect, signed by your physician. It is the medical insurance companies who usually deem something as “not medically necessary,” not the disability insurance’s. I’m just shocked. I might just write a letter on her behalf, maybe we should write a petition.
Lisa @ Unfiltered Insanitys last blog post..Dear So and So-Mother in Law Edition
Oh, and I know that you already corrected the statement about her purchasing her insurance when she signed up for benefits, not when she knew about the surgery, but that is common sense. You cannot purchase a plan through your company’s benefits at any time. There are open enrollment dates and they are rarely at the most convenient time. I think that the people who thought that she would buy the coverage with the knowledge that she was going to have this surgery…. well, I don’t know what I think OF them since I don’t know any of them, but I think it’s sad that anyone would say that about someone who’s trying to save her life.
Anyway, that being said, even if she COULD do that, she still signed a contract that she would pay “x” amount of money and in return, if she needed to cash in on that contract that she would be taken care of. So, yeah. Petitions, state representatives, whatever y’all need to do to get this corrected, should get done.
That shit ain’t right.
DCUrbanDads last blog post..What every DC Urban Dad needs…..
Thanks so much, TSM for helping your friend this way. I’m currently trying to get Military medical to pay for my prophylactic mastectomy. AT the same time, I am thankful that I have fabulous insurance and never need to worry about coverage. I hope she can find an answer, for her and all other moms who need to live for their children.
Sailor Jennys last blog post..In which I explain (or don’t) my deployment.
I am wondering if the insurance were a government one suggested by the bills, would it be generous enough to pay?
wow! what a powerful story! maybe it will get back to obama if it is tweeted enough. he has a lot of pull, i hear.
my prayers are with her and her son.
bexs last blog post..Gabe Gabe Bo Babe
Hi TSM – has she contacted an insurance lawyer to go over her policy? They should be able to provide her with a written opinion based on her policy and how the law applies in her case. Best of luck to you friend!
M
That is a total nightmare. She needs a lawyer, big time.
The Lawyer Moms last blog post..An Orgasm a Day Keeps Teen Pregnancy at Bay?
Dude, what a crock!
I’ll pass the word.
Amos last blog post..Weekly Lessons LEARNED
She can file a lawsuit against the insurance companies. I worked for an attorney in FL that specialized in suing insurance companies as contract disputes. In Florida, if you win your suit the insurance company is required to pay all of your legal expenses.
I just wrote to mutual of omaha. This is everyone’s worst nightmare. I pray every day, I don’t lose the insurance I have. I have never been so afraid.
Jessicas last blog post..And it just so happens to come in my favorite color…..
This is so timely, it give me chills. Read my post from two days ago and PLEASE share it with your friend, in case she doesn’t already know about BBP: http://www.halfpastkissintime.com/2009/07/be-bright-pink-giveaway.html
Off to Tweet!
I think that the people who thought that she would buy the coverage with the knowledge that she was going to have this surgery
But people do do that. Not saying that this woman did, but how many people buy auto insurance just to get their license or tags renewed and then drop it the next month?
wow, I am def going to let as many as i know about this, and send prayers.