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Man Denied Health Care Coverage Gets Surgery

DANBURY, Conn. — Matt Cote is recovering after undergoing surgery following a car crash. The procedure almost didn’t take place because his insurance company denied him health care coverage.

Repeated rejections by three insurance companies in eight years led to Doctor David Kloth to intervene in Matt Cote’s case.

“Every day, I probably see about 10 patients who are being denied health care by their insurance carrier,” said Doctor David Kloth.

“I was probably walking around with a pain level of eight every day. Percocet to start the day, Percocet to end the day,” said Matt Cote.

A car accident left Cote with three ruptured discs in his lower back. Dr. Kloth prescribed a minimally invasive procedure, aimed at reducing the pain, risks, recovery time and meds. But Cote was denied coverage at every turn.

“That would be okay if they understood the evidence in the literature. What they do is they bring in doctors who might be a methodologist or a statistician or to be honest, won’t even have a specialty in the same field that’s being examined,” said Dr. Kloth.

Recently, Dr. Kloth operated on Cote and chose the procedure he initially recommended, with no cost to Cote. The years of frustration motivated Dr. Kloth to get all those involved, from equipment to anesthesia, to donate their services.

“If Matt had undergone the larger operation which a number of years ago, the insurance company wanted him to do, he would have been in the hospital for about five days post-op and then likely would have gone to a rehab facility such as a nursing home type facility for about a two week period to recover,” said Dr. Kloth.

Instead Cote is walking and the prognosis is positive.

“A week out, I am functioning. I’m up and walking for a few minutes and that’s better than I could hope for,” said Cote.

Now this grateful patient can put his health care battle behind him.

“There’s nothing worse than hearing, having a doctor tell you what you need and saying look I can fix you and I can get you better but the insurance company won’t do it,” said Cote.

According to Dr. Kloth, insurance companies should look at cases based on the patient’s need.