Bronx family heartbroken over continued rejection from insurance company

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THE BRONX, NY (PIX11) – It’s heartbreak after heartbreak for a Bronx family after a father, who was diagnosed with a rare cancer, was denied three times by his insurance company for what they say is a life-saving operation.

Despite the denials, they aren’t giving up hope, but they say time is running out for Anthony Di Laura.

“I’m sitting here in pain,” Di Laura told PIX11 News in an exclusive interview. “Every day is a battle.”

For two years, he has been fighting Pseudomyxoma Peritonei, or PMP. The National Organization for Rare Diseases has said that two in a million people are diagnosed.

Di Laura’s wife, Jackie Cucullo, fought the difficult journey by his side.

“It was born from a tumor in the appendix and then spread to other abdominal organs,” Cucullo said.

Mucin grew in Di Laura’s stomach, so he underwent major surgery to remove the infected stomach organs. Yet the cancer has not gone away. The chemotherapy didn’t cure him either.

What makes the trip even more difficult is that Di Laura’s family say he was approved for life-saving surgery by doctors at the Cleveland Clinic in Ohio, but their insurance denied the transplant. multiple organs three times.

“How is it possible?” asked Di Laura. “We were approved for all the tests at the clinic before the transplant.”

A denial letter from Empire Blue Cross Blue Shield said the operation was “investigative”.

“[It says] that it hasn’t been done many times,” Cucullo said. “They keep asking for more documentation which I know has been provided.”

Ohio surgeon Dr. Anil Vaidya completed the operation on another patient in this condition and was successful.

Di Laura’s family said the operation was their last hope after another surgeon told them the mucin in her stomach was turning into cement.

They are optimistic about the ability to overcome this obstacle, as they have already overcome challenges. Cucullo was told she could never get pregnant, but a few months after Di Laura’s diagnosis, the couple welcomed a baby boy.

“We just decided it was God’s plan,” Cucullo said. “We had a miracle and that’s it. We are totally happy and ready to move on.

That was until the second miracle happened and Cucullo was pregnant again. Their baby girl is only two weeks old.

They believe their third miracle will succeed with an approval for surgery. In the meantime, they lean on each other.

“You don’t see that these days, that type of love,” Di Laura cried. “I wouldn’t be here, really, if it wasn’t for her taking care of me.”

Because Di Laura and Cucullo have exhausted their three appeals with the insurance company, an independent external review with New York State is their next and last chance for approval. The family said the Cleveland Clinic hospital was submitting the paperwork on Tuesday and an expedited decision was expected about five days later.

The family raised more than $100,000 on GoFundMe, but they say the operation could cost between $500,000 and $1 million without insurance.

PIX11 News has contacted the insurance company for comment and is awaiting a response with a statement.

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