Far out Friday: Ruptured breast implant causes a ruckus for insurer

by IBO 17 Jul 2015

Far out Friday: Ruptured breast implant causes a ruckus for insurer

The aftermath of an auto accident involves a lot of adjuster work, looking after client vehicles and covering hospital and doctor bills. However, a June car crash in Denver, USA is complicating coverage for one insurer—the woman involved wants payment for cosmetic surgery after the crash ruptured one of her breast implants.

Preferring to remain anonymous, the woman told Denver’s CALL7 that the ruptured implant left her feeling “broken” and “less of a person.” However, nearly eight months later, she is still waiting to see if her insurer will confirm whether the $5,000 it sent her may be used for the necessary plastic surgery.

According to the company, the insurance money may be used for “reasonable and necessary” medical treatments caused by the accident. The woman’s doctor believes plastic surgery falls under that heading.

“The doctor has sent a statement that this is necessary,” said personal injury attorney Michael Sawaya, adding that “she has a part of her body that is now deformed. If she decided to have her body look a certain way and they’ve deformed it, this is a medical expense.”

The insurance company wants the woman to have the surgery and then submit receipts for reimbursement, but the woman would like the assurance that the procedure will be covered before moving forward.

The delay has been emotionally painful, she told CALL7.

“Part of being a woman is to look in the mirror and see a whole person,” she said.