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Dying mother takes her plea for a new liver directly to the insurer UnitedHealth



"Nobody should fight and work so hard, especially when all these doctors say it will save my life."


Erika Zak

Erika Zak, 38, has written two of the most important letters of her life in recent months: one, just in case her 4-year-old daughter is reading on an indefinite day in the future, and a second, David Wichmann, CEO The UnitedHealth Group, should be read immediately.

Before that it was too late.

Her daughter was only a few months old in 201

4 when Zak learned that the pains of a pregnancy were really stage 4 of metastatic colorectal cancer that had spread to her liver after a long time. Profile of Zak and husband Scott Powers and their experience , with CNN. The course of treatment that followed in the next few years included chemotherapy and liver surgery that caused some damage, "a consequence of complications after microwave ablation," as their physicians in their home state of Oregon and the renowned Cleveland Clinic would do

It was this liver damage and not the liver cancer that caused the demand for an organ transplant that her team of doctors approved last February, but UnitedHealth

UNH + 1.96%

had denied that it was not a "promising treatment".

There were vocations and more rejections. And so were also high fever and increased risk for Zak.

And so Zak reported in April to Wichmann, the CEO, what she thought was a rigged review process pervaded with mistakes that her life was not worth.

"Since my life is in limbo on the basis of this review," she wrote, "it is unreasonable that it was not done with the level of competence and professionalism one would expect from UHC."

It blew up what she called the "shockingly incompetent species" in which the country's largest insurance company handled her case. She outlined what she described as a series of errors in the review – from UHC saying her liver failure stems from "chemotherapy toxicity" to an insurance director, who falsely said she had "life-threatening lesions."

Both are not true, "she wrote to Wichmann. "(UHC's) handling of my case has been plagued by unnecessary delays, incomplete answers, inefficient planning, conflicting statements and, worst of all, repeated factual errors in my medical history."

Despite their request, the answer was the same: Denied.

And no proof that Wichmann had actually read the letter. The correspondence with UnitedHealthcare continued as her patient adviser worked on Zak's case.

Your concerns were valid. "What drives liver transplantation in this case is liver failure and NOT liver metastases from colorectal cancer, which makes the patient's oncology post-transplant more encouraging," Dr. Federico Aucejo, director of the clinic's Cleveland Liver Cancer Program, in a request to Erika on behalf of March 6, according to CNN. He noted that she had chemotoxicity, which was a secondary cause of liver failure.

Read: How to count on your doctor every minute

"Waiting for the insurance to approve the only thing that will save me: a liver," Zak wrote on Instagram. "I'm waiting for my liver to fail completely, wait for death, I'm waiting to be rescued."

Zak's surgical oncologist in Oregon said nobody at the insurance company had approached him during the review process, "the facts "This is worrying," he told CNN, especially if it's one of the most complicated cases a doctor will ever see. Zak's doctors make it clear in the profile that a transplant operation is not without major risks and that their cancer could return, but even returning cancers can be treated with standard treatments such as chemo or surgery, which prolongs their lives.

Read: Texas Woman Dies for 116-Dollar Compensation for Flu Medication Expensive

On May 2, Zak and her husband received a call from UnitedHealthcare and held their breath [19659004] Denied.

An evaluating physician had moved slightly in favor of Zak. The other two kept their original position. But the agent was also worried that the process took longer than normal and promised that nothing would be missed.

Five days later, on May 7th, a surprise follow-up call came. Called: Approved

UnitedHealthcare declined to answer CNN's questions about treating Zak's case, except to make a unilateral statement: "We had ongoing discussions with her husband and contacted him as soon as the decision was made to transplant . "

Did her letter work somehow, even though she never heard of the executive? Or was it the intercession of her husband and her medical team? Was it the recognition by the insurance agent in the 11th hour that the process sounded flawed?

It is possible that all of these methods or more were used. And that's exactly why Zak has told CNN to continue with the story to speak out for others who have experienced the pain of similar denials, she said. To let them know that they are not alone. To encourage them to be their own best advocates.

Why? It can mean the difference between life and death.

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