title: A family member's legal experience with an insurer's refusal to recertify inpatient mental health treatment.
abstract: 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.
authors.forename: M
authors.initials: M
authors.lastname: Shyovitz
mesh_terms: D001714:Bipolar Disorder / Q000534:rehabilitation*; D002568:Certification / Q000331:legislation & jurisprudence*; D002648:Child; D003134:Commitment of Persons with Psychiatric Disorders; D006760:Hospitalization; D006801:Humans; D007348:Insurance, Health; D008297:Male; D010344:Patient Advocacy; D016079:Refusal to Treat / Q000331:legislation & jurisprudence*