Renton family wins lawsuit after insurance company fails to cover autistic teen

BY KIRO Radio Staff  on April 1, 2012 @ 9:11 am (Updated: 11:37 am - 4/2/12 )

A Renton family has won a lawsuit that forces Primera Blue Cross to cover their son's therapy for autism. John and Kirsten Griffen are also suing the company to pay for the therapy their son Aidan has already received.

For the past four years, 13-year-old Aiden has received occupational and speech therapy for autism after he was diagnosed at the age of eight. But in August, Primera canceled his treatment and sent his parents a bill for $24,000.

"There's no moral reason why we should treat those people differently," attorney Richard Spoonemore explained to KING TV. "If we give coverage for one we should get coverage for all and that's what the [Mental Health] parity act in Washington says."

John told KING-TV on Saturday that he was shocked when Primera announced that they were going to stop covering Aidan's speech and occupational therapy.

"I remember talking to them on the phone and saying you can ruin a family like this if this is how your process works," Griffen said.

Premera Blue Cross issued a statement saying, "Our plans are to fully comply with the state law that mandates coverage of neurodevelopmental therapy. All health plans in Washington are addressing challenges that seek to obtain greater coverage."

The company Primera insists that the Griffins still owe them $24,000 for past therapy sessions. The Griffins disagree, and that matter is still working its way through the court.

KIRO Radio Staff, Staff report
Straight from the newsdesk.
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Comments (5)


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  • Howard goldman wrote...
    This story is lacking some information
    April 1, 2012 11:32 am
    I think we should know which parent is covered by Primera Blue and then how much are they paying out of pocket? Are they getting this coverage via their employer? How much deductible have the met? Is there an Out of Packet Maximum? Physical and Occupational Therapy is EXTREMELY expensive and this story is not saying how many sessions Primera is going to pay for and if the parents are taking the insurance company for a ride. Usually there is a limit like Eye exams. Usually you get one every 12 months. Now if you started going to an eye exam every other week then you would expect to pay. The story creates the picture like the insurance company just of the blue said you owe this money.
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  • messiah101 wrote...
    Howard G
    April 1, 2012 1:36 pm
    When are you going to catch on that Nortwest publishes only enough info to get an emotional response from its viewers. They don't dig for facts or for reasons.You will do yourself a big favor if you ask yourself why??on most any story seen here
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  • Irish Rover wrote...
    What a shame !
    April 2, 2012 8:40 am
    Shame on "noscreenname" that he would post such an ignorant and repugnant remark. Secondly, if legitimate, Shame on Primera for not doing the right thing up front and taking care of children diagnosed with autism. Families go through enough trying raise children born with physical and/or mental deficiencies; they should never have to go to court to compel their insurance to do the right moral and legal things.
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  • BallardAaron wrote...
    This story is lacking
    April 3, 2012 11:56 am
    some basic accuracy! It's Premera, not Primera. If they can't get that basic fact right, how can they be trusted to have any of the rest of the article right?
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • { "Thumbs Up":"1","Thumbs Down":"-1" }