Experimental Treatment DenialsPeople pay for health insurance coverage to protect themselves in times of need. However, insurance companies sell coverage to make money. A common tactic used by insurance providers to deny claims for expensive medical services is by classifying them as “experimental” treatments. Unfortunately, for many people these so-called experimental treatments may mean the difference between life and death. At the law office of Jonathan M. Feigenbaum, Esquire, our Denied insurance claims attorney is committed to resolving claim denials for both Employment Retirement Income Security Act (ERISA) and non-ERISA health benefits, including denials based on experimental treatment.
Skilled and Knowledgeable Legal RepresentationWhile coverage can vary from state to state and insurers can make exceptions for certain treatments, our experience in medical benefits litigation has taught us that just because an insurer claims that a treatment is experimental does not necessarily mean that it is not covered. Most cases come down to complex health insurance policy language. Providers will interpret policy terms and contract provisions in order to fit their needs. However, this rarely aligns with an individual’s medical needs. Attorney Jonathan M. Feigenbaum understands the interaction of the medical and the legal. We handle cases for denied claims classified as experimental treatments, including those involving:
- Lyme disease mistaken for multiple sclerosis, which is harder to treat later
- Non-radiation cancer therapy, which is typically more expensive than radiation therapy
- Bone marrow transplants that have been around for years
- Less risky proton therapy treatment for prostate cancer
- Double-cervical disk replacement, which is used frequently in Europe, but not the U.S.
- Cancer treatments