Health: Dental Dispute
PHILADELPHIA (CBS) - This holiday season is brighter for a Delaware County grandmother after 3 On Your Side helped get her over $600 she was owed from an insurance company. Medical Reporter Stephanie Stahl has the story.
73-year-old Anna Marie Ettorre is finally able to eat without pain, and isn't embarrassed to smile or be seen in public.
The front teeth of her partial denture broke, and needed to be replaced. But her insurance company United Concordia refused to reimburse her.
Stephanie asked, "But it was clearly a mistake?"
Anna Marie replied, "Yes, definitely."
Her insurance had paid for some of her dentures in the past, but there were limits on her coverage. In 2006, they weren't covered, so she paid $6,000 dollars for new dentures. But in July when she was eligible, and her front teeth needed to be replaced, insurance refused to pay.
"They said you paid for it in 2006, that is the same as if we paid for it," said Anna Marie.
Stephanie asked, "What did you think when you heard that?"
Anna Marie replied, "I thought somebody was nuts."
She just kept getting the run-around, and finally turned to 3 On Your Side for help.
"Then the wheels started turning, everybody listened. But when you're by yourself, nobody listens," said Anna Marie.
Within days of our phone calls to her insurance company, Anna Marie got her money.
"This is the check for $643. Yes," said Anna Marie.
Stephanie said, "That's nice to see?"
Anna Marie replied, "It sure is."
Along with the check, Anna Marie got a letter from the insurance company.
Anna Marie read the letter that said, "I apologize for any inconvenience this matter may have caused to you."
The insurance company refused to tell us what happened specifically in Anna Marie's case, only that she should have followed the appeals process, and it would have been resolved.
Reported By: Stephanie Stahl, CBS 3
