The Insurance Intelligencer
2/25/08

Emotional Aspects of Writing an Appeal

People often assume that my mission in life is to write appeals, fight peoples' battles for them, be a patient advocate. That would be wrong.

There are many these days who are hanging out their shingle as "patient advocates." They charge by the hour, get down in the trenches, fight the battles one by one. That would not be me.

I have done my time in the trenches. I have written dozens of winning appeals. Now it is your turn.

This is not about doctors, and it is not about insurance. If I thought that it was, I would retire from Insurance Warrior-ing tomorrow. This is about life. At the very moment when you feel the most terrified, you are given the opportunity to win a great victory. Winning that victory yourself will grow you in compassion, give meaning to your suffering ... it will transform you. But only if you embrace it.

If I had been diagnosed with a garden-variety cancer, I would have lined up at my local oncologist's office, taken whatever standard treatments they were dishing out, and lived or died by it. Instead, I was diagnosed with an unusual-but-not-rare cancer.

Because of this twist of fate, I was given the opportunity to ..

  • Do fascinating research.
  • Confer with the finest G.I. surgeons in the country.
  • Write an appeal that would help others.
  • Become a published author.
  • Become a public speaker.
  • Join with others to win great victories.
  • Help people to save their own lives.

In short, I found my true voice.

Who knows what your hero's journey will do for you? It certainly won't do anything for you if you don't take the bull by the horns, find the best treatment, then personally jump into the trenches and slug it out with your insurer.

Now you have a book. It will be easier for you than it was for me.

What is it that stops people from confronting their insurers, and writing their appeals?


Anger

The type of anger that will affect your appeal is ... anger at the insurance company. "I will die if I don't get this treatment! I've paid my premiums for twenty years! They are supposed to take care of me!" It is very easy to take this personally -- sort of like a family member suddenly chasing you around the house with an axe.

If anger would win your appeal, I would say have at it, act like Yosemite Sam, holler to your heart's content. However ... the fight with the insurance company is a very high stakes strategy game. You don't win a game of strategy by hollering, screaming, and throwing your cards on the floor in a rage. You win by keeping a cool head, constantly looking for openings, not showing your hand. By staying one step ahead of your opponent.

Anger against a faceless bureaucracy will do nothing but sap your energy. This is why I say, "The only reason to call your insurance company is to find out where to write to." The Customer in whose ear you are hollering has no decision-making power. No insurance company has changed their position because of a phone conversation. Put down the phone, take a deep breath, and start writing your appeal.

We have a finite amount of energy to fight our medical and insurance battles, and we can't afford to waste it on anger.


Fear

"What if I confront my insurer, and they retaliate?"

Short answer? Not gonna happen. In writing thirty winning appeals, no insurance company has ever retaliated. Why not? Because we aren't just complaining, pestering, or making idle threats. With our fact-filled written appeals, we establish ourselves as a force to be reckoned with. If we have done our job, the insurer suspects that we might be an attorney.

I was probably the first seriously-ill cancer patient to hit my HMO with twenty-eight page War Documents. Did they cut me off? Did they throw me out? Do they snarl at me when I come in for an appointment?

Quite the contrary. I am treated with such a level of respect, I half expect them to roll out the red carpet, take my coat, and hand me a latte.

And I have experienced the same with my many helpees. The stronger the appeal, the better they will treat you in future.

Facing your fear of insurance companies is an important part of your hero's journey. Confront your insurer with your head held high. You will regain your power, and you will find your voice.


Denial

In order to fully embrace the insurance battle, we have to recognize that we are in Big Medical Trouble, with Big Financial Trouble nipping at our heels.

When we do our research, we become fully aware of the precarious medical place in which we find ourselves.

When we press the doctors for answers, and they say, "You will die of this disease," "You have two good years left," "There is no treatment" ... we realize how close we have come to disaster.

When we engage with the insurance company, we see how determined they are not to pay all for our care.

Taking the insurance bull by the horns is scary, indeed.

But not as scary as the alternative.


Philosopher's Corner

I am nearing the third anniversary of my diagnosis with a late-stage, metastasized abdominal cancer. On March 17, 2005, I was rushed into surgery, and given months to live. On June 4, 2005, I was told by the famous Dr. Two Good Years, "You have two good years left."

When I visited the HMO recently, the doctor said, "I thought you had moved." I could see that what she really thought was, "I assumed that you had died."

So not so. I continue to be exceedingly alive.

Laurie Todd