Insurers Continue to Rely on Doctors Whose Judgments Have Been Criticized by Courts
www.propublica.org
In dozens of cases ProPublica reviewed, judges found that some doctors working for these companies engaged in “selective readings” of medical evidence and “shut their eyes” to medical opinions opposing their conclusions.

Summary

ProPublica investigates health insurers’ reliance on controversial doctors to deny mental health treatment.

Highlighting Emily Dwyer’s case, it details United Healthcare’s rejection of coverage for her anorexia treatment, despite evidence she was gravely ill.

Courts have criticized insurers for “arbitrary and capricious” denials, with judges pointing to factual errors and dismissive reviews by company-hired psychiatrists.

While some families, like the Dwyers, fought back in court, most lack resources to challenge insurers.

Critics call for reforms as denials often worsen health outcomes and highlight systemic issues in mental health care access.

  • @cymbal_kingEnglish
    6•5 days ago

    ProPublica is an amazing nonprofit investigative journalism source and they never have a pay wall. Consider donating!

    They also have a tool to help you file claims to your insurance company

  • snooggumsEnglish
    11•5 days ago

    Capitalists don’t care about criticism, only action. The courts words mean nothing if they aren’t backed up by something the companies have to actually respond to.

    If courts take action and the capitalists don’t stop doing the bad thing, then the action wasn’t enough.