UPSON COUNTY, Ga. — After paying more than $100,000 for cancer insurance over almost 30 years, a retired Georgia teacher is fighting back because she says the insurance company denied most of her claims following her diagnosis.
Patricia Hayes, a retired Thomaston-Upson district science and math teacher, started paying for her cancer insurance in 1996, starting at $37 a month. Over the years, her premiums skyrocketed to $681 per month by 2020.
In 2021, she was diagnosed with metastatic breast cancer. She thought her Manhattan Life policy would help her cover her treatments, but it only covered a percentage. She received $2,530 for her treatment.
“I have this cancer policy. It should come to my rescue. But it hasn’t,” Hayes said, holding back tears.
Her experience echoes broader issues within the insurance industry. A study by the Kaiser Family Foundation found that six in 10 insured adults face challenges using their insurance, with 18% reporting denied claims in the past year.
Financial expert Shavon Roman believes that Hayes’ situation isn’t hopeless.
“There is probably at least $100,000 in this contract that she could be paid out for today,” Roman said. She emphasized that understanding how to navigate policies is crucial.
Roman recommends several steps for those facing similar challenges:
- Avoid accepting written denials without speaking to an agent.
- Ask insurers to specify why claims are being denied under the terms of the contract.
- Contact your insurance agent to get a detailed explanation of your benefits.
Roman suggested Hayes could receive reimbursement for expenses like preventative screenings, travel, and home care could be possible with detailed receipts.
Hayes added she will continue to fight.
“I’m not going to stop. I’m just more determined,” she said.
Manhattan Life has not yet responded to 11Alive's request for comment after several attempts.