'Insurance Warrior' helps fight claim rejection - WMC Action News 5 - Memphis, Tennessee

'Insurance Warrior' helps fight claim rejection

Keith Skates Keith Skates

(WMC-TV) - Have you ever been denied an insurance claim? One man decided he was not going to take 'No' for an answer and he did it by calling the "Insurance Warrior".

One look at Keith Skates and you'd think he had it all, a nice home, a happy family, but last year, life threw him a curve ball.

"At that point the doctor dropped a bomb, said you have a very rare form of appendix cancer. That is a one in a million type of cancer," said Skates.

It was a rare cancer that needed a rare surgery and the right surgeon.

"Take tumors out and flood the abdomen with a chemotherapy bath," he explained. "There is no one in Alabama who has done enough of these for us to have gone to."

But when Skates found a doctor in Washington, D.C. who specialized in the treatment he needed, his insurance company would not cover the out-of-network costs. He would have to choose from the insurance company's list of approved surgeons.

"Five of them had nothing to do with the type of cancer I had, never done anything with it," Skates explained. "The other four did deal with abdominal cancer but only one had ever done the type of surgery that needed to be done. It was on a very minor case. He'd only done one ever."

Skates could not leave his life in the hands of someone who had little to no experience with his disease.

"That was really the motivation, knowing the kids depend on ya. You got to get better," he said.

So, he called the "Insurance Warrior".

Laurie Johnson Todd has spent the past eight years helping patients in similar situations. Her passion for this line of work comes from her own experiences.

"I was told there was no treatment for my disease and even if there were, they wouldn't pay for it," Todd said. "So I found the world's expert on my advanced cancer and then I fought my doctors and my insurance company to get them to pay for it."

Todd takes on only a handful of cases, so she wrote a book that empowers the customer in a process where only the policy holder has control.

"Really, the patient, you're the one who holds the contract with them and you're the one who can hold their feet to the fire in terms of getting the one effective treatment to the disease. The patient's the only one," she said.

In her book, Laurie details the steps to take to appeal an insurance company's denial.

She helped Skates with his.

"Basically what you do is present a story to the insurance company explaining why you should be covered, why should use this particular doctor, and why the other doctors they recommend would not be the proper way to go," he explained.

Todd has personally helped 111 people fight and win their insurance appeals.

Thanks to her help, Skates was lucky number 103.

"Don't take no for an answer. Don't take, 'We'll call you back for an answer.' Don't let them send you to voicemail. There's somebody who can help you," he said.

Skates went to Washington D.C. for what will hopefully be his last surgery, all covered by his insurance because of his appeal.

If you are interested in getting a copy of the "Insurance Warrior's" book, click here: http://www.theinsurancewarrior.com/

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