Renton family sues insurance company for autism coverage [KCPQ/KMYQ-TV, Seattle]

March 31--SEATTLE -- From the time Aidan Griffin was a baby, his parents said he was always fascinated by things that would spin or rotate. Aidan's interest in such things didn't dissipate and today, the 13-year-old Renton boy's bedroom is home to a collection of clocks.

When he was 8, doctors diagnosed Aidan with autism. His parents, John and Kirsten Griffin, had been noticing that Aidan wasn't interacting with other kids and he was extremely sensitive to sound.

For the last four years, Primera Blue Cross, the Griffin's health insurance company, has covered Aidan's speech and occupational therapy -- until now.

"Usually when you get your bill from the insurance company it's a regular-sized envelope. We got a giant envelope with a big stack of forms dated back to January 2010 saying we owed $24,000," John said.

The Griffins are suing the insurance company and are working with Seattle attorney Richard Spoonemore to fight for autism coverage for all Washington families.

Spoonemore has also filed seven class-action lawsuits locally and federally against other health-care insurers like Regence Blue Shield and Group Health Cooperative.

"It doesn't make sense," said Spoonemore. "They'll cover somebody who smokes cigarettes their entire life and gets lung cancer and cover everything from a lung transplant to chemotherapy. But a child who, through no fault of their own, is born with a developmental disability, they give you nothing."

Kathy Griffin said paying for therapy is incredibly expensive, even with insurance coverage.

"People are losing their homes and choosing between food and services for their children because these services do help. They're just not cheap," she said.

For the Griffins, this treatment had made a huge difference in their son.

"Now, after years of getting this therapy we're able to see him run up and down the basketball court, swimming, and interacting with his peers in ways that as parents we didn't think we'd ever get to experience with him," she said.

This week, a King County judge ruled Primera must cover continuing therapy for the Griffin's son, but a court case on his past benefits is still ongoing.

A spokesperson with Primera said that "our plans comply fully with the state law that mandates coverage of neurodevelopmental therapy. That mandate applies to group coverage, for members up to age 7, but does not apply to the individual market. Meanwhile, all health plans in Washington are addressing challenges that seek to obtain greater coverage for neurodevelopmental therapy."

The spokesperson said they could not comment further because the issue is not the subject of an ongoing litigation.

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