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Type 1 Diabetes Mellitus: when insurers say no, reviewers often say yes
In 20 published external-review decisions involving type 1 diabetes mellitus, independent physician reviewers overturned the insurer’s denial 70% of the time.
Published decisions
20
2001–2026
Overturned
70%
14 denials reversed
How to use this in your appeal
These outcomes come from California’s external review program — an independent physician panel whose decision binds the insurer. Every state has an equivalent, and internal appeals succeed even more often. If your care for type 1 diabetes mellitus was denied, the published record says the denial is worth fighting.
SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY
Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.