WWII vet fights health insurance company after not getting care

NEWPORT BEACH, Calif. (KABC) -- A 92-year-old World War II veteran has filed a lawsuit against his insurance company. He says the company is giving him the runaround, forcing him to pay out of his own pocket for care.

Bill Crawford does his best to get around, but he admits he needs more help these days. He is legally blind and is healing after a hip replacement.

"I fell and broke my hip so I was bedridden and in a rehab facility after the operation for a month," Crawford said.

It was at that time in May 2012 Crawford said he was initially relieved he had long-term healthcare insurance. Crawford recalls watching his mother in her final years struggling with no insurance. More than 20 years ago, Crawford signed a policy with Continental Casualty Company, or CNA, to avoid the same fate.

"I figured they would be taking care of me," he said.

But two years after filing his first claim, Crawford says he has yet to receive a dime from CNA.

"One time they said they lost the file, this was after a while, another time they said, 'Well, it's under review,' but every time we sent in a claim, claim denied," Crawford said.

Crawford has filed a lawsuit. His attorneys allege CNA places demands on policyholders that are so confusing that the only purpose could be to "cook up grounds to deny claims."

Crawford says his insurance agent did not tell him his policy was a reimbursement plan, meaning he would have to hire and pay for care upfront and submit receipts to try to get his money back

After paying nearly $60,000 out of pocket, Crawford says he's supplied CNA with all documents requested, from doctors' notes verifying his ailments, to his caregiver's timesheets. CNA says it cannot discuss individual claims due to privacy laws.

"We are committed to fair and proper claim handling for all of our customers, and we strive to provide our policyholders with the highest level of customer service and treatment," Jennifer Martinez-Roth, media relations director of Continental Casualty Company, said in a statement.

William Pavone is a decorated Vietnam veteran and Crawford's neighbor. Pavone is now helping care for Crawford for free, since Crawford has had to cut back his caregiver's hours to save money.

"He's owed this money," Pavone said. "I mean he's paid into it, he should be receiving the benefits that he expected."