PHILADELPHIA (WPVI) -- A new website is designed to help if your insurance company denies your claim for mental health care. Joe Feldman from Illinois said about nine years ago, his daughter required some serious intervention when she was in high school. He and his wife got her the care her doctors said she needed, but their insurance refused to pay for it.
So, Feldman sued and won. Now, he's determined to help other families. "We bought health insurance, like anyone, because someday you might need it.
And when that moment of truth came, our insurance company wasn't there for us," he said. The reason? "The reason was not medically necessary, which was a determination made by a third party psychiatrists that our insurer had hired. Someone who had never met our daughter, never reviewed her files, and didn't listen to her therapist, or her psychiatrist," he said.
The Feldmans' appeal was denied so they ended up paying $100,000 out of pocket, taking money from their savings. Feldman said they had no choice because the treatment was necessary to save their daughter's life. "Families should not have to go through what we went through to get mental health care for their family members or for themselves," he said.
Feldman won a lawsuit in federal court, but said many others are not so lucky. He estimates at least 15 million claims for mental health or substance use disorder care are denied each year. And according to a 2020 survey by the National Alliance on Mental Illness, nearly on.