Cigna denied my wife's stage III breast cancer reconstruction claiming the contralateral prophylactic mastectomy was 'cosmetic' even though her BRCA2-positive status and the WHCRA mandate the coverage. Overturned in 14 days using a Section 502(a)(1)(B) ERISA appeal letter, the WHCRA citation, and the NCCN Guidelines. The federal-law framework that breaks 'cosmetic' denials cold
Posting this because the "cosmetic procedure" denial is one of the most common and most legally indefensible bad-faith tactics carriers use against breast cancer reconstruction claims, and the federal...