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Fight Your Health Insurer and Win: Secrets of the Insurance Warrior
Secrets of the insurance warrior
- GenresNonfiction
Paperback
First published January 1, 2007
About the author
Laurie Todd
6 books7 followersLaurie Todd is an author, teacher, and insurance strategist.
In 2005, Laurie was diagnosed with late-stage appendix cancer. She was told by her oncologist, "There is no treatment for your disease. And, even if there were, they wouldn't pay for it."
Ms. Todd succeeded in persuading her insurer to fully cover her lifesaving treatment with Dr. Paul Sugarbaker, the world's expert on appendix cancer. The cost for the extensive surgery, intrapertoneal chemotherapy, and forty days in hospital was $345,000. Her share? Nine dollars.
During the past four years, Laurie has written forty-four winning insurance appeals, for lifesaving treatments costing from $100,000 to $500,000. Many insurers, many conditions/diseases, all over the United States. She has never lost a case.
In 2007, Laurie secured the backing of a major cancer foundation to publish her groundbreaking book, "Fight Your Health Insurer and Win: Secrets of the Insurance Warrior." This book has helped hundreds to win their own insurance battles.
Laurie's second book, "The Sample Appeal: More Insurance Warrior Wisdom" came out in May 2009.
Laurie has addressed general audiences, healthcare professionals, cancer patients and caregivers, social workers, and benefits administrators. In May 2009, she addressed an audience of two hundred doctors and patients at the Liver Symposium in Chicago.
Articles by Laurie have appeared in "Coping with Cancer" magazine (July-August 2008), and also in the YES (Y90 Microspheres Education and Support) newsletter.
In 2005, Laurie was diagnosed with late-stage appendix cancer. She was told by her oncologist, "There is no treatment for your disease. And, even if there were, they wouldn't pay for it."
Ms. Todd succeeded in persuading her insurer to fully cover her lifesaving treatment with Dr. Paul Sugarbaker, the world's expert on appendix cancer. The cost for the extensive surgery, intrapertoneal chemotherapy, and forty days in hospital was $345,000. Her share? Nine dollars.
During the past four years, Laurie has written forty-four winning insurance appeals, for lifesaving treatments costing from $100,000 to $500,000. Many insurers, many conditions/diseases, all over the United States. She has never lost a case.
In 2007, Laurie secured the backing of a major cancer foundation to publish her groundbreaking book, "Fight Your Health Insurer and Win: Secrets of the Insurance Warrior." This book has helped hundreds to win their own insurance battles.
Laurie's second book, "The Sample Appeal: More Insurance Warrior Wisdom" came out in May 2009.
Laurie has addressed general audiences, healthcare professionals, cancer patients and caregivers, social workers, and benefits administrators. In May 2009, she addressed an audience of two hundred doctors and patients at the Liver Symposium in Chicago.
Articles by Laurie have appeared in "Coping with Cancer" magazine (July-August 2008), and also in the YES (Y90 Microspheres Education and Support) newsletter.
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Displaying 1 - 7 of 7 reviews
August 24, 2009
Laurie Todd learned the hard way that having health insurance is no guarantee of getting the treatment you need when you get really, really sick. When she was diagnosed with a rare form of appendix cancer, her HMO refused to pay for the only effective treatment because it was considered experimental and done by a doctor who was out-of-network.
Fight Your Health Insurer and Win is the story of how Todd appealed that decision and succeeded in getting her HMO to pay for her surgery. Todd did not have a legal background when she began her odyssey, but by paying close attention to the details and doing her own legwork, she was able to prove to her HMO that there were no in-network physicians competent to perform her surgery and that this supposedly experimental treatment was considered the "standard of care" by another insurance company.
Since succeeding in her own appeal, Todd has written successful appeals for patients all over the country. This book is designed to be a how-to guide for others seeking to appeal their own denial of care. Towards that end, it explains the inner workings of insurance companies and their networks, what specific insurance terminology means and how to use it to your advantage, and what sort of evidence you need collect to counter the most common denial arguments. She includes the outline of her appeal and the text of numerous letters she wrote in the process. In addition, there is advice on things like how to establish precedent by finding others who have gotten your insurance company to pay for the treatment they are attempting to deny you and how to navigate the Social Security disability process.
The hard details of how to successfully appeal a denial of care are interwoven with elements of Todd's personal story. Todd also shares no-nonsense wisdom about how to cope with what she calls Bad Medical Trouble, particularly when the people around you have no concept of what you are going through. There is a strong emotional tone underlying her writing, a passion infused by the unconscionable unfairness of a corporation placing profit over the lives of its customers. But Todd is no cheerleader; she is a hard-core pragmatist who understands from personal experience that there are no guarantees in this life. That's no reason to go down without a fight, however, and for those who want to know they have done everything they possibly can to give themselves the best chance of survival, hers is an exceedingly useful book.
Fight Your Health Insurer and Win is the story of how Todd appealed that decision and succeeded in getting her HMO to pay for her surgery. Todd did not have a legal background when she began her odyssey, but by paying close attention to the details and doing her own legwork, she was able to prove to her HMO that there were no in-network physicians competent to perform her surgery and that this supposedly experimental treatment was considered the "standard of care" by another insurance company.
Since succeeding in her own appeal, Todd has written successful appeals for patients all over the country. This book is designed to be a how-to guide for others seeking to appeal their own denial of care. Towards that end, it explains the inner workings of insurance companies and their networks, what specific insurance terminology means and how to use it to your advantage, and what sort of evidence you need collect to counter the most common denial arguments. She includes the outline of her appeal and the text of numerous letters she wrote in the process. In addition, there is advice on things like how to establish precedent by finding others who have gotten your insurance company to pay for the treatment they are attempting to deny you and how to navigate the Social Security disability process.
The hard details of how to successfully appeal a denial of care are interwoven with elements of Todd's personal story. Todd also shares no-nonsense wisdom about how to cope with what she calls Bad Medical Trouble, particularly when the people around you have no concept of what you are going through. There is a strong emotional tone underlying her writing, a passion infused by the unconscionable unfairness of a corporation placing profit over the lives of its customers. But Todd is no cheerleader; she is a hard-core pragmatist who understands from personal experience that there are no guarantees in this life. That's no reason to go down without a fight, however, and for those who want to know they have done everything they possibly can to give themselves the best chance of survival, hers is an exceedingly useful book.
June 13, 2012
This is a great book. Most people have no idea the power they have in appealing a medical claim. Laurie is the expert. I met her at my Myelooma Support Group and we have emailed back and forth for two years now. She is an angel. She has saved more lives by helping them appeal an insurance rejection for medical care that has been previously paid by the same insurance company, but they decided to not cover to save money. What a racket! Insurance Companies are out of control. Laurie is my kind of person. She will not let you give up. Read her book and find out how many people she has saved.
August 23, 2026
Incredibly outdated.
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June 29, 2009Latest review from Midwest Book Review
Fight Your Health Insurer and Win
Laurie Todd
Healthwise Publications
PO Box 2045, Woodinville, WA 98072
www.theinsurancewarrior.com
According to Reader's Digest in April of 2006, seven in ten adults who were driven into debt by medical expenses had insurance at the time. Author Laurie Todd had health insurance when she was diagnosed with a rare form of cancer, but in order to obtain the expensive treatment necessary to save her life, she had to battle her insurance company tooth and nail. Fight Your Health Insurer and Win: Secrets of the Insurance Warrior is a distillation of what she learned—a lifesaving, no-nonsense guide written especially for sufferers of cancer and other deadly medical afflictions. Chapters cover how to qualify one's own doctors (and make sure one's provider is not only generally competent, but an expert in one's specific affliction), manage one's own care, find the best care possible for one's disease, and force one's health insurer to bear the full cost (a common practice among insurers is to pay an "out-of-network benefit" that covers only 60%-80% of the cost—which is just not enough when some surgeries can cost, $200,000 or more). Also discussed are how to research the life's work of one's physician on Google and ask him questions about his practice (it's important to listen to the tone of the answers as well as the answers themselves); why terms like "experimental/investigational procedures" and "medically necessary" are little more than manipulative word-dancing meant to frighten away people from demanding insurance payment; how to respectfully and persuasively present one's case to insurance industry bureaucrats and medical professionals who have a vested financial interest in your imminent death (if you die quickly, they don't have to pay for your treatment); and much more. Sample letters, step-by-step procedures, guidelines for telephone conversations, and above all the admonition to never give up infuse Fight Your Health Insurer and Win with literally life-giving energy and wisdom. Highly recommended, and an absolute "must-have" for anyone who has paid their health insurance dues.
Susan Bethany
Reviewer
http://www.midwestbookreview.com/rbw/...
Fight Your Health Insurer and Win
Laurie Todd
Healthwise Publications
PO Box 2045, Woodinville, WA 98072
www.theinsurancewarrior.com
According to Reader's Digest in April of 2006, seven in ten adults who were driven into debt by medical expenses had insurance at the time. Author Laurie Todd had health insurance when she was diagnosed with a rare form of cancer, but in order to obtain the expensive treatment necessary to save her life, she had to battle her insurance company tooth and nail. Fight Your Health Insurer and Win: Secrets of the Insurance Warrior is a distillation of what she learned—a lifesaving, no-nonsense guide written especially for sufferers of cancer and other deadly medical afflictions. Chapters cover how to qualify one's own doctors (and make sure one's provider is not only generally competent, but an expert in one's specific affliction), manage one's own care, find the best care possible for one's disease, and force one's health insurer to bear the full cost (a common practice among insurers is to pay an "out-of-network benefit" that covers only 60%-80% of the cost—which is just not enough when some surgeries can cost, $200,000 or more). Also discussed are how to research the life's work of one's physician on Google and ask him questions about his practice (it's important to listen to the tone of the answers as well as the answers themselves); why terms like "experimental/investigational procedures" and "medically necessary" are little more than manipulative word-dancing meant to frighten away people from demanding insurance payment; how to respectfully and persuasively present one's case to insurance industry bureaucrats and medical professionals who have a vested financial interest in your imminent death (if you die quickly, they don't have to pay for your treatment); and much more. Sample letters, step-by-step procedures, guidelines for telephone conversations, and above all the admonition to never give up infuse Fight Your Health Insurer and Win with literally life-giving energy and wisdom. Highly recommended, and an absolute "must-have" for anyone who has paid their health insurance dues.
Susan Bethany
Reviewer
http://www.midwestbookreview.com/rbw/...
April 11, 2011
Laurie Todd combines personal experience with helpful how-tos to show her readers how to kick insurer butt. For those of you who haven't inferred this from other summaries, synopses, tag lines, etc., Fight Your Heath Insurer is for, as Todd puts it, "Bad Medical Trouble." Knowing nothing about this book except it's title, I thought, "Hey, maybe we can get our crappy HMO pay for the eye doctor we've been seeing for 25 years!" Not so. You could try some of Todd's tactics for this goal, and you might get further than if you didn't use said tactics, but this kind of insurance provider pestering might best be saved for the big things, lest insurance companies make successful pestering harder. Not a happy way to look at things, but for-profit insurance providers are money-grubbing poo-heads like that.
Todd's efforts focus on "Bad Medical Trouble," not, "I don't like the eye doctor you're making me go to." As such, she focuses her book on how to get an insurance company to pay for top-of-the-line treatment for a "rare" cancer, since this was how Todd learned the information she shares. However, Todd also makes it easy to adapt the techniques, letters, information, etc. that she has provided reader with to something like the back surgery that will allow your dad to get out of bed. Or perhaps the preventative treatment that will keep your dad from needing surgery and that will probably cost less due to its lack of invasive-procedure-ness and highly-paid-surgeon-needing-ness. Not for elective procedures, this book is an excellent source for insurance-fighting-ammo, so that you may win the war against your insurance provider to live a longer, healthier life.
Personally, I truly appreciate Todd's perspective on good and bad things: "[Buddhists say] Every life has ten thousand joys and ten thousand sorrows. If I aspire to avoid the sorrows, I will also avoid the joys. Life is short. I want it all." All good vs. evil dichotomies drive me nuts, because the goal of good is to eradicate evil. But how can we know something is good if there is no evil? It's a two-sides-of-the-same-coin idea that I feel like people don't understand. Todd not only understands this idea, but expresses it in a way that I find easy to grasp and share (though this doesn't come up in conversation that often, so my chances for sharing are going to be few).
Todd's efforts focus on "Bad Medical Trouble," not, "I don't like the eye doctor you're making me go to." As such, she focuses her book on how to get an insurance company to pay for top-of-the-line treatment for a "rare" cancer, since this was how Todd learned the information she shares. However, Todd also makes it easy to adapt the techniques, letters, information, etc. that she has provided reader with to something like the back surgery that will allow your dad to get out of bed. Or perhaps the preventative treatment that will keep your dad from needing surgery and that will probably cost less due to its lack of invasive-procedure-ness and highly-paid-surgeon-needing-ness. Not for elective procedures, this book is an excellent source for insurance-fighting-ammo, so that you may win the war against your insurance provider to live a longer, healthier life.
Personally, I truly appreciate Todd's perspective on good and bad things: "[Buddhists say] Every life has ten thousand joys and ten thousand sorrows. If I aspire to avoid the sorrows, I will also avoid the joys. Life is short. I want it all." All good vs. evil dichotomies drive me nuts, because the goal of good is to eradicate evil. But how can we know something is good if there is no evil? It's a two-sides-of-the-same-coin idea that I feel like people don't understand. Todd not only understands this idea, but expresses it in a way that I find easy to grasp and share (though this doesn't come up in conversation that often, so my chances for sharing are going to be few).
December 9, 2008
The author has good ideas. I believe there are few sources for this type of information. I had it long time before I could get to use it. I marked pages that gave me ideas. When I finally read it, it took me maybe an hour to skim through it.
September 16, 2015
A very good read. Laurie Todd is a good writer. Short and too the point, she walks us through the steps to winning an insurance denial, with examples from her own fight. Her story of Serious Affliction is also very compelling.
Displaying 1 - 7 of 7 reviews