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Parents Take on Aetna to Fight for Coverage for Their Daughter

Two New York City police officers are valiantly taking on an insurance company in order to force it to continue paying for their permanently disabled daughter’s care in a rehabilitation center.

According to documents filed in Manhattan federal court in litigation against the insurance company, Aetna is trying to stop paying for the 20-year-old woman’s in-patient care. The parents allege Aetna is trying to force her to be cared for at home on the taxpayers’ dime.

The accident occurred in November of last year. The girl and her mother, a sergeant with the New York City Police Department who was off-duty at the time, were driving in Brooklyn’s Marine Park. Their vehicle was struck by a livery van being chased by police at high speeds through the borough.

The parents’ lawsuit claims that the insurance company is attempting to reduce the coverage level that would keep their daughter a patient at Sea View Hospital Rehabilitation Center. Allegedly, it is Aetna’s position that the young woman’s care at the center isn’t “medically necessary.”

A spokesperson for Aetna said that the company has “covered significant rehabilitative and medical costs for this member and continue[s] to do so.”

This case is illustrative of the reasons it is necessary to file suit against insurance companies after an accident. Injuries from wrecks can be permanently disabling, leaving the injured parties requiring 24-hour care and supervision for the rest of their lives. Even if an insurance company initially appears to be helpful and responsive to the needs of the injured, they can later downgrade their coverage. If a suit was not timely filed on behalf on the injured party, they lose their right to pursue compensation later.

Whenever you are in doubt about an injury and the compensation that is offered by the insurance company, it is wise to seek legal guidance.

Source: New York Post, “Aetna says rehab not ‘medically necessary’ for permanently disabled daughter: suit,” Josh Saul and Julia Marsh, Sep. 22, 2015