I was sitting in the waiting room for the third time that week when the insurance coordinator looked me dead in the face and told me my daughter’s treatment had been DENIED – again.
Petra is six. She has been sick since she was four, and we have spent the last two years fighting a disease that moves faster than the paperwork that’s supposed to save her.
I’m Donna. I work nights at a distribution center so I can keep Petra’s insurance. I haven’t slept more than four hours straight since February.
The first denial came in March. I cried, called the number on the back of the card, got transferred four times, and ended up leaving a voicemail that nobody returned.
The second denial came six weeks later. Different reason, same result.
This third one, the coordinator – a woman named Brenda, badge clipped to a lanyard with little suns on it – slid the paper across the desk like she was handing me a grocery receipt.
“There’s an appeals process,” she said.
I took the paper. I thanked her. I walked back to the plastic chair where Petra was coloring a horse purple and sat down next to her.
That night I started reading.
Not the denial letter. The insurance company’s OWN POLICY DOCUMENTS. All 214 pages. I printed them at the library.
I found it on page 187. A clause that said treatment could not be denied when two or more attending physicians documented medical necessity. Petra had THREE.
I went back through every denial. Every single one cited a different reason.
They were ROTATING the reasons so no single denial could be appealed on the same grounds twice.
My hands were shaking when I put it together.
I called a patient advocate named Curtis who a woman in the waiting room had written on a napkin for me two weeks ago. He told me what I had was enough to file a bad faith complaint with the state insurance commissioner.
We filed on a Thursday.
The following Monday, a man in a suit I’d never seen before was waiting at the front desk when Petra and I walked in.
He asked if I was Donna Schreiber.
Then he said, “Before we go any further, you should know – we’ve been instructed not to speak to you without your attorney present.”
I Don’t Have an Attorney
I stood there holding Petra’s hand and I looked at this man and I said, “I don’t have an attorney.”
He blinked. Adjusted his tie. He was maybe forty, dark hair going gray at the sides, the kind of suit that costs more than my car payment.
“You’ll want to get one,” he said.
Petra tugged on my sleeve. She wanted to know if the fish tank in the corner had a shark in it. I told her probably not. I told her to go look.
She went. I stayed.
The man handed me a card. His name was Greg Fallon. He worked for a firm I’d never heard of. He said he was representing the insurance company’s interests in what he called “the matter currently before the commissioner’s office.”
I asked him why he was here, at the clinic, instead of somewhere official.
He said he’d just wanted to introduce himself.
I took his card and put it in my coat pocket next to a crumpled receipt from the gas station and Petra’s spare hair tie.
That was a Tuesday. By Wednesday I had called eleven attorneys.
Eleven Calls
Not one of them took the case.
Most were polite about it. One was not. He told me, and I’m quoting him exactly, that insurance bad faith litigation against a carrier this size was “a years-long commitment with unpredictable returns” and that without a clear damages calculation it was hard to get excited.
Hard to get excited.
I wrote that down. I don’t know why. I just did.
Curtis, the advocate, had a list of three legal aid organizations. The first had a six-month waitlist. The second didn’t handle insurance cases. The third called me back four days later and said they might be able to assign someone in eight to twelve weeks.
Petra’s next treatment window was in three weeks.
I went back to the library. I’d been going most nights after my shift ended, before I had to be home when my neighbor Gail left for her own job at six-thirty. The librarian there, a man named Ray who wore the same cardigan twice a week, had stopped asking me what I was looking for. He just pointed me toward the corner desk with the good lamp and left me alone.
I started reading about pro se representation. About how to file motions. About what “bad faith” actually means under state insurance law.
I am not a lawyer. I want to be clear about that. I graduated high school, did two years of community college, dropped out when my mother got sick. I work a forklift. I know how to read a pallet manifest and I know how to keep my eyes open at three in the morning when everything in my body is telling me to stop.
It turns out those are useful skills.
What I Found in the Commissioner’s Own Database
The state insurance commissioner has a public complaint database. Most people don’t know this. I didn’t know it until Ray showed me.
I searched the insurance company’s name.
There were 340 complaints filed in the last four years. I filtered by denial type. Thirty-one of them mentioned rotating denial reasons. Eleven of those were for pediatric cases.
Eleven kids.
I printed every single one. Ray let me use the staff stapler.
I went home, laid them out on the kitchen table, and read through them while Petra slept. She makes a sound when she’s sleeping, a small one, like she’s trying to say something. I’ve never been able to figure out what.
Three of the eleven complaints had been resolved. All three listed the same outcome: “Carrier agreed to cover treatment. Complaint withdrawn.”
No fines. No findings. Just gone.
I called Curtis the next morning. I told him what I found. He was quiet for a long time.
“Donna,” he said. “Do you still have Greg Fallon’s card?”
I did. It was still in my coat pocket.
“Don’t call him yet,” Curtis said. “Call the commissioner’s office first. Ask to speak to whoever handled those three resolved complaints. Ask them by name.”
The Woman Who Picked Up on the First Ring
Her name was Beverly Marsh. She was a senior investigator in the commissioner’s consumer protection division. She picked up on the first ring, which surprised me so much I forgot what I was going to say for a second.
I told her Petra’s name. I told her the dates. I told her about the rotating denials. I told her about the eleven complaints and the three that disappeared.
She said, “How did you find the eleven?”
I told her. The database. The filters. The library.
Another pause. Shorter this time.
“Mrs. Schreiber,” she said, “I need you to email me everything you just described. Tonight if possible.”
I told her I’d do it from the library at eleven PM because that’s when I had time.
She said that was fine.
I asked her, because I had to ask, if this was going to matter. If any of it was going to move fast enough.
She didn’t answer that directly. What she said was: “I’ve been in this office for fourteen years. I’ve seen carriers do a lot of things. What you’re describing, if it holds up, is not a gray area.”
I didn’t know what to do with that so I just said thank you and hung up.
The Second Man in a Suit
I emailed Beverly everything that night. Ray helped me scan the printed complaints because the scanner at the library is the kind that jams if you look at it wrong, and he knew the trick.
Three days later, Greg Fallon called me.
Not the clinic. My cell phone. I don’t know how he got the number.
He said the company wanted to schedule a meeting to “discuss Petra’s case and explore potential resolutions.” He used the word resolution twice. He said they wanted to make sure Petra was getting the care she needed.
I said I’d have to check my schedule.
I called Curtis. Curtis called Beverly. Beverly told Curtis that the commissioner’s office had formally opened an investigation two days ago and that Greg Fallon calling me directly was, in her words, “not ideal for them.”
I called Fallon back and told him I wasn’t available to meet.
He said, “Mrs. Schreiber, I want to be clear that the company is prepared to move quickly here.”
I said I appreciated that. I said I’d be in touch.
I hung up and sat in my car in the parking lot of the distribution center for six minutes before my shift started. It was cold. The heater in my car takes a while.
I thought about page 187. I thought about Petra coloring that horse purple. I thought about eleven kids.
Then I went inside and worked my shift.
What Happened on a Wednesday
Beverly called me on a Wednesday morning. I was asleep. I’d gotten home at six-fifteen, gotten Petra to school by seven-forty, and fallen into bed at eight.
My phone rang at nine-fifty.
I picked up because I’d set Beverly’s number as a contact.
She said the commissioner’s office had issued a formal finding. The carrier had engaged in a pattern of bad faith denial practices across multiple pediatric cases. They were being fined. The amount was not small. And as a condition of the settlement, they were required to immediately authorize all pending treatments for affected policyholders.
Petra was on the list.
I asked Beverly to say that again.
She did.
I said, “So it’s approved?”
She said, “It’s approved.”
I was sitting on the edge of my bed in the same clothes I’d worn to work. My socks didn’t match. There was a water stain on the ceiling I’d been meaning to deal with for two years.
I looked at it.
I didn’t cry. I thought I would. I’d been running so long on the idea that crying was something I’d do later, after, when there was time. And then there was time and I just sat there.
Petra came home from school that afternoon and told me her teacher had let them watch a movie about penguins. She said penguins were actually “kind of mean” and she seemed personally offended by this.
I made her a grilled cheese and told her she was right, penguins were probably mean.
I didn’t tell her about the approval. She’s six. She doesn’t know what the word denial means. I want to keep it that way for as long as I can.
What I Want You to Know
I am not special. I want to be really clear about that.
I’m tired and I’m not a lawyer and I printed 214 pages at the library because I didn’t have a printer and I ran on bad coffee and four-hour nights and a napkin with a phone number on it.
What I had was time. Barely. And I used every minute of it.
There are other Petras out there. I know because I read their complaints. Eleven of them, filed by people who were probably just as tired as me, who hit the same walls and maybe didn’t have a Curtis or a Ray or a Beverly who picked up on the first ring.
If you are in it right now, here is what I know:
Print the policy documents. All of them. Read page 187 or whatever your page 187 is.
Check your state’s insurance commissioner complaint database. It’s public. Use it.
Ask every person in every waiting room if they know anyone who can help. The napkin thing worked.
And if they tell you to get a lawyer, and you don’t have one, that’s not the end. It wasn’t for me.
Petra’s first approved treatment is scheduled for next Thursday. She has already informed me that she wants to stop for a donut on the way, the kind with sprinkles, and that she wants a purple one if they have it.
I told her I’d find her a purple one.
I will find her a purple one.
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If this story is someone else’s fight right now, pass it to them. It might be the thing that helps them find their page 187.
For more heart-wrenching stories about difficult family situations, read about When My Daughter Went Limp in My Arms at the ER Desk and the Clerk Told Me to Sit Down or My Daughter Saw the Screen Before I Could Close It. And if you’re looking for more tales of betrayal, check out My Wife Told My Best Friend I Could Never Find Out. I Was Standing Right There..
