Centennial Couple Feels Scammed After Insurance Denies Claim for Son’s Birth
CENTENNIAL, Colo. — A local couple, McClinton and Brie Heil, expressed their frustration after their hospital indemnity insurance denied coverage for their son Haynes’ birth, leaving them feeling deceived during what should have been a joyful time.
The Heils welcomed Haynes at Rose Medical Center, calling it an excellent facility with a caring team. However, their experience turned sour following the birth. After enrolling in MetLife’s hospital indemnity insurance in November 2023, they believed they were prepared for their upcoming costs, especially as the insurer’s promotional materials suggested such plans were suitable for expectant parents.
Despite their timely enrollment, the couple found their claim denied three months post-delivery on the grounds that pregnancy was a pre-existing condition. In a letter received in September 2024, MetLife stated that because Brie was pregnant before enrolling, the claim fell under the pre-existing condition clause.
“This is shocking; I never thought pregnancy would be considered a pre-existing condition,” said Brie. The couple subsequently filed a complaint, only to receive confirmation that the denial stemmed from pre-existing condition limitations.
Health law expert Govind Persad highlighted the pitfalls of hospital indemnity plans, noting they lack the regulation of Affordable Care Act protections, which could lead to ambiguous interpretations of coverage.
“No one should have to feel scammed,” McClinton emphasized, urging others to be aware of the fine print in insurance policies. He encouraged prospective buyers to check if their policies cover pre-existing conditions and to consult with their employer’s HR department for clarity on any doubts.
As the Heils navigate this challenge, they hope to inform others about the intricacies of insurance policies this holiday season.