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A Family Member’s Legal Experience With an Insurer’s Refusal to Recertify Inpatient Mental Health Treatment

Marcy Shyovitz, MA, JD

Published: January 12, 2001

Article Abstract

My son Nathaniel has bipolar disorder and was hospitalized for 6 months, during whichtime our insurance company was prepared to refuse certification more than once despite apolicy that included 365 days of inpatient mental health treatment. A break in coverage bythe insurance company would have meant that Nathaniel, still suicidal, would not receive thelife-saving care he needed. Fortunately, I am a lawyer, which enabled me to act as a legaladvocate for my son when our insurer threatened not to recertify. Because my son’s experiencewith the insurance company is not unusual—many patients with mental illness strugglewith insurance companies who refuse to certify treatment—I believe that the family or supportpeople of seriously ill psychiatric patients should be prepared to act in circumstancessimilar to mine. Psychiatric inpatient units should, as a matter of course, provide informationon legal remedies that can be obtained before irreparable harm occurs.

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