Patients Email CEOs to Overturn Insurance Denials

Two patients have successfully overturned insurance denials for critical treatments by emailing company chief executives. Elizabeth Nicholas, 36, and Donald E. Grant Jr., 49, both faced initial refusals for medically necessary care before their direct appeals to leadership prompted approvals.

Elizabeth Nicholas was diagnosed with breast cancer. After months of treatment, her insurer refused to cover the chemotherapy her oncologist recommended. Donald E. Grant Jr., an industrial-organizational psychologist from Valley Village, California, has severe congenital cervical stenosis. An in-network surgeon performed a two-level artificial disc replacement in December 2025, but by March 2026, imaging showed new myelomalacia spreading across four vertebral levels. Grant developed bilateral foot drop, lost sensation in his lower legs, and experienced hand numbness, weakness, and new bowel and bladder problems.

How patients fought back

Both patients pursued unconventional routes to overturn the denials. Elizabeth Nicholas wrote about her experience in Vanity Fair last month. She then emailed her insurance company's CEO and subsequently received approval from the company's chief scientific officer.

Donald E. Grant Jr. used Claimable, an AI-assisted appeal platform founded by Warris Bokhari, to create an 11-page legal and medical appeal. The document argued his insurance lacked any in-network surgeons with qualifications comparable to his chosen specialist, Dr. Hyun Bae, a leading authority on multilevel cervical arthroplasty at Cedars-Sinai. The appeal invoked federal urgent-care claim regulations demanding a 72-hour decision, cited specific subsections of claims-procedure rules, and requested the complete claim file under ERISA and HIPAA. It explicitly demanded that no algorithm or automated tool be used in deciding his appeal, backing this with references to litigation and a Senate investigative report.

Grant sent the appeal to UnitedHealth Group's CEO and copied more than a dozen others, including UnitedHealthcare executives, Optum's chief medical officer, a California state senator, the lieutenant governor's office, Attorney General Rob Bonta, and health care reporters. He also copied David Ellison, the CEO of Paramount Skydance, who is the ERISA plan administrator for the self-funded plan paying the claims.

Insider perspectives on fighting denials

Former insurance company executive Wendell Potter wrote about these cases in his newsletter. He told MedPage Today that taking concerns to the top is a strategy more people should use, noting that cases investigated by reporters were often raised when he worked at Cigna. Potter stated few patients initially know how to fight a denial, and getting care approved required significant research for both Nicholas and Grant. He suggested doctors, who may understand the system better, could consider similar tactics but acknowledged that frequent complaints could risk being kicked out of a network. Potter emphasized that such escalation should not be necessary.

Healthcare policy advocate Eagan Kemp told MedPage Today it is absurd that patients and providers must spend so much time getting necessary care approved and must contact C-suite officials. Kemp added that this dynamic is why Medicare-for-All is gaining traction, as it would cut out middlemen.

Outcome and broader implications

UnitedHealthcare approved Donald E. Grant Jr.'s procedure with Dr. Hyun Bae at the in-network rate, clearing the way for surgery scheduled for October 14. Dr. Bae was one of the physicians who ran the original FDA trials for the device in Grant's neck, and UnitedHealthcare had no in-network surgeon with comparable qualifications. Grant noted that UnitedHealthcare employees were responsive and patient in helping him understand the approval and costs. He reflected that while this time it worked out well, he realizes this is not always the case.

What this means for patients and providers

The cases highlight that individual persistence can sometimes break through systemic barriers. However, experts warn that relying on patients to personally email CEOs is not a sustainable solution. They point to the need for broader reform to ensure medically necessary care is approved without requiring extraordinary measures. The success of these direct appeals shows deep flaws in the standard insurance appeals process, where clinical need alone is often insufficient for coverage.