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Lost dentures

Sunday, May 1, 2016

Adam was rushed to the hospital. By the time he was admitted into the emergency ward, Adam was in such pain that he was not fully conscious.

It took three months, but Adam was finally well enough to be discharged. Unfortunately, he could not find his dentures. He guessed that the dentures went missing early on during his stay while he was largely incapacitated from the intense pain and medication. Adam asked the health authority to help find his dentures.

The health authority conducted a search of the hospital but, unfortunately, did not find Adam’s dentures. Denture replacement is not cheap, so Adam asked for help paying the deductible – his medical insurance would cover the rest of the cost. When the health authority declined to reimburse Adam for
the deductible, he contacted us for help.

We asked the health authority how, in this case, it applied its client valuables and personal effects policy. Specifically, we noted that the policy provides a greater obligation to incapable and incapacitated clients, and that designation seemed to apply to Adam.

After reviewing Adam’s emergency room records and medical charts, the health authority agreed Adam could be considered incapable at admission and at various points throughout his stay. Further, Adam’s medical charts mentioned his dentures but not when they went missing.

As a result of our investigation, the health authority agreed to reimburse Adam for the cost of his deductible to replace his dentures. Adam was pleased with the results.