Let me first say that this is a terrible situation, and I very much disagree with this insurance company's decision. However, many people here seem to be using this an argument for public healthcare, when the same problem exists in our (Canadian) system. As another poster said earlier, it's simply a corporate bureaucrat vs. a government bureaucrat, either way they both have to justify the costs. I've got two stories to illustrate my point, both about family friends:
One of my parents friends was diagnosed with cancer. The doctors here in Canada told him that they would not offer him treatment (other than for pain), estimated that he had six months to live and told him to get his affairs in order. Not being content with this, and in the position to do so, he travelled to the Mayo clinic for a second opinion. The doctors there could not believe that our doctors would not offer treatment; they wrote up some paper work recommending immediate commencement of chemotherapy and sent him back. Our system refused to take this recommendation, told him what they had before and left it at that. He has since been travelling regularly to the States for his treatment, and instead of six months has lived for three years.
Another friend went to her doctor with symptoms that were potentially consistent with both uterine cancer and benign cists. The doctor examined her and concluded that it was more likely that she had benign cists, and sent her home with a treatment plan for that. There was a test he could have run to conclusively tell which condition she had, but refused to do so because of the cost. Five weeks later her condition had gotten worse, so the test was finally performed - oops, turns out it was cancer. Unfortunately she passed away several months later. I'm not going to argue that the earlier testing would have saved her life for sure, but it would have at least given her a better chance.
I'm not going to argue which system is better, I'm just pointing out that this same flaw is present in both systems.
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