Health Insurance: Laura Nataf, disabled, still has to fight to be reimbursed

This is a story that would give rise to the vocations of lawyers and even journalists: professions whose common denominator is the will to be justices in this world. I read it, watched the testimony of the young woman who suffered a septic shock at the age of 19. I shut down my computer. But, being sick like Laura and experiencing unexplained blockages from part of the administration, I found it cowardly not to react, not to have compassion! No, that would be unworthy of me.

So I took my phone and courage on my shoulder to just share Laura Nataf’s story with my readers. Sorry Laura, for this access to primary cowardice. In the 21st century, this cannot be experienced in France, where we boast of having the best health care system in the world, a system in which, I must remind you, health insurance is integrated.

It doesn’t matter the influence struggles or lobbies I immediately dissociate myself from, because the epicenter of the problem remains Laura Nataf. I must point out that I do not know and may not know about my life. But, fed up with these injustices that are multiplying in our country. Are we from Munich? I’m afraid we will become one!

First of all, the facts: Laura Nataf, who suffered a septic shock at the age of 19, spent a month in a coma. When she wakes up, she is amputated from all 4 limbs. Ten years later, thanks to the audacity and skill of French Professor Laurent LANTIERI and American Professor Scott LEVIN, she is again able to get past the nail polish on her own. The transplant of his two forearms and his two hands, performed in 2016, is indeed successful. Happy Ending ? That Nenni, we’re not in Hollywood, for sure. Otherwise, Laura’s fight should have stopped there. The young woman should focus only on education and new life.

But no, she had to start a new battle, with the help of her lawyer, Master Valérie SELLAM BENISTY, knowing that the PENN MEDICINE Hospital in Philadelphia, where she underwent surgery on August 22 and 26, 2016, he is claiming more than $ 700,000 for care.

Or, “The CPAM of Paris has refused to pay, in a totally arbitrary way, the charge of this double transplant abroad, despite a judicial procedure of last July 12, more than 4 years after the facts, at the end of which the Tribunalul Judiciaire de Paris annulled refusal to take care of care abroad and sentenced CPAM to pay Laura € 671,671.00 for part of her care ” the lawyer revolts. And deploration:“A decision challenged by the social organization, which does not pay and appeals on August 17. From this date, the Health Insurance will seek to save time and allow this file to drag… It does not draw conclusions, does not communicate its documents. ». Today, the Health Insurance seems to protect its discretion to grant or re-provide care abroad without fear of obvious discrimination between the fate of different patients observing that in the species, It forgets that the naked refusal of Laura NATAF is based on any medical advice from the Social Security Physician, which is the fundamental element of a position.

Actually, “In exceptional cases provided for by the legislature, it is the written and motivated opinion of this health professional who must be communicated to the social insured who determines the position of the body. How could Laura NATAF have been content with the mere mention of an “unfavorable opinion” from the Physician-Consultant even though this advisory opinion was never produced in the debates! »precisely the lawyer.

Faced with these dilatory maneuvers, Maître Valérie SELLAM BENISTY (pictured with her client) therefore filed a 69-piece enamelled cross-appeal, including new evidence gathered for the first time in the case of an appeal she reserves for her pleadings. The new hearing, open to the public, will take place on June 23 at 1:30 pm in front of the Pôle 6 – 13th chamber of the Court of Appeal in Paris. Allons supports Laura Nataf. At least for her to get back to a normal, anxiety-free life.

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