A Family Member's Legal Experience With an Insurer's Refusal to Recertify Inpatient Mental Health Treatment
J Clin Psychiatry 2001;62(suppl 25):44-50
© Copyright 2016 Physicians Postgraduate Press, Inc.
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My son Nathaniel has bipolar disorder and was hospitalized for 6 months, during which
time our insurance company was prepared to refuse certification more than once despite a
policy that included 365 days of inpatient mental health treatment. A break in coverage by
the insurance company would have meant that Nathaniel, still suicidal, would not receive the
life-saving care he needed. Fortunately, I am a lawyer, which enabled me to act as a legal
advocate for my son when our insurer threatened not to recertify. Because my son’s experience
with the insurance company is not unusual—many patients with mental illness struggle
with insurance companies who refuse to certify treatment—I believe that the family or support
people of seriously ill psychiatric patients should be prepared to act in circumstances
similar to mine. Psychiatric inpatient units should, as a matter of course, provide information
on legal remedies that can be obtained before irreparable harm occurs.