Well, that is my appeal. I know these guys are heavily regulated and hemmed in by government and the appeal will be quickly denied. But I will have a little satisfaction that some insurance bureaucrat had to read my letter and send out a standard form letter denial.As per a letter dated xxxxxx, from xxxxxx, Director, Individual Membership, I am writing regarding the recent rating due to the following conditions: Anxiety/stress and sleep apnea.
Regarding the diagnosis of anxiety/stress, when this diagnosis was made the medical professionals failed to diagnose the underlying cause which was obstructive sleep apnea. In December 2005, I was diagnosed with obstructive sleep apnea and began continuous positive airway pressure (CPAP) therapy. After a poor start with CPAP due to an incorrect pressure prescribed, I eventually had the machine set to an effective pressure and began getting an excellent CPAP therapy. Since this time I have no anxiety/stress problems and use no drugs or other treatments for anxiety/stress.
Regarding the diagnosis of sleep apnea, I do have obstructive sleep apnea. However it is treated effectively with CPAP. I am 100% compliant with CPAP and my therapy is very effective. I have CPAP monitoring software (Respironics Encore Pro) and monitor the effectiveness of my therapy on a daily basis.
Since beginning the CPAP therapy, I was able to increase my physical activity. I now exercise regularly and vigorously and have reduced my BMI from 25 to 22. I practice good nutrition and sleep hygiene. I rarely visit the doctor except for checkups. When I do visit the sleep doctor, I take my Encore Pro CPAP reports with me and review the high effectiveness of my CPAP therapy with the doctor.
I would appreciate it if you would review my file and consider a different rating which would result in a lower premium for my medical insurance. Thank you for your assistance, and I look forward to hearing back from you.
I thought about telling them that 50% of their policy holders have sleep-disordered breathing and 95% of those are untreated and will likely have many more claims than me.
Comments before I mail the letter will be appreciated.
