Question:
Anybody have 'contract exclusion' and still have surgery?

Has anyone ever had the insurance company tell them that there is a 'contract exclusion' with the company you work for, when the company says they know nothing about it? The insurance co. refuses to provide written denial, saying that it is excluded by contract. If you have had this happen how did you get written denial, how did you fight it, and did you win? Thanks!    — CatLover1964 (posted on June 11, 2002)


June 11, 2002
Sounds like you need Walter Lindstrom. Website is obesitylaw.com. They specialize in fighting insurance problems and their rates are very reasonable when compared to the cost of Surgery. Email them about your situation and they will give you an idea of what they can help you with.
   — Dell H.

June 11, 2002
Linda - WLS was exluded from our contract by my husband's employer. I asked the people at the ins co (Blue Cross of Minnesota) "Now what do I do?" The girl was completely unsympathetic and said "well, nothing, you just can't have the surgery unless you pay for it yourself". My husband also spoke to someone in human resources at work and they told him basically the same thing. She said it wouldn't do us any good to fight it, that another employee also tried to no avail a few months before. I sent an e mail to Walter Lindstrom and never heard back. I ended up paying for my surgery. I equate it to buying a fancy new car that'll take me five years to pay off. (Only I'll get a lot more miles!!! I've lost 48 lbs in 2 1/2 months and have 52 lbs to go to goal.)
   — Bridget C.




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