David Denney, 13, who was severely brain damaged as a baby, has the motor development of a 4-month-old, and requires a stomach tube to eat and help moving his limbs, the Los Angeles Times reported Sunday. Until two years ago, Blue Cross of California, the family's insurer, paid for a full-time nurse who watched him to make sure he didn't choke on his food, and exercised his arms and legs.
But then the insurer began rejecting claims for the nursing care, which cost about $1,200 a week, so the Denneys hired a lawyer.
The couple are just two of a growing number of frustrated individuals fighting insurers who have rejected their claims, the newspaper said. Since 2001, the number of similar actions against California insurers has more than doubled to about 1,000.
A 17-year-old girl died this month after her health insurance company, CIGNA Corp. (NYSE:CI), delayed a liver transplant.
For the last two years, California's Medicaid program, Medi-Cal, has paid for 40 hours per week of nursing.
A spokeswoman for Blue Cross said the company will not comment on a pending action.