Quadruple amputee loses court against health insurance

Health Insurance had been ordered to pay 700,000 euros to Laura. The Paris Court of Appeal overturned this decision. A shock for the young woman.





By Martin Pereira

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Un huge shock. Laura, 35, has just lost a legal battle that she thought was unstoppable. The Paris Court of Appeal has just overturned a court decision which obliged Health Insurance to pay him 700,000 euros. A huge sum which is equivalent to part of the costs that the young woman had to incur to have two hands and two forearms transplanted in the United States, as recalled The Parisian.

To fully understand Laura’s situation, you have to rewind to 2007. While a student at the Ecole hôtelière de Lausanne (Switzerland), she did an internship in Barcelona. She wakes up one morning with violent symptoms, boring fatigue and migraines. The young woman can no longer eat or get up. Laura is urgently repatriated to France, placed in an artificial coma. She is the victim of a toxic shock, contracted because of sanitary tampons. When she wakes up, the young woman realizes that she has had four limbs amputated.

The idea of ​​a transplant

As time passes, the shock passed, the thirty-year-old decides to register on the list of transplants. “I was on the waiting list for three years, but nothing happened until this sentence of 2016: for lack of donors, I was removed from the lists. In reality, I never had an explanation! “, she recalls. The young woman then decided to go for a transplant in the United States. Health insurance refuses to cover the exorbitant costs: they amount to more than one million euros.

In 2021, Laura partially wins her case in court. Health insurance must reimburse him 700,000 euros, or two thirds of the costs. The Paris Court of Appeal has therefore just changed the course of this case. “I find it disgusting! Behind the big health insurance machine, there was no humanity, justice has just shown that it has none either, ”she asserts. His lawyer, Mr.e Valérie Sellam-Benisty, abounds: “It is written that what is invoked is valid, but that the judge cannot replace the administration, it is to understand nothing. We absolutely did not expect this brutal decision. »

This transplant, she explained two years ago, had been a necessary step to rebuild herself psychologically. With this court decision, Laura will have to take responsibility for all the expenses: 990,000 euros. Nearly a million euros that the Philadelphia hospital, which advanced the costs, is now claiming.


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