If insurance won't approve the Roosevelt

M

mama a llama

New member

• Jan 7, 2010

• #1

Are we better off just taking the Traveller Plus Snug Seat that the seating clinic said they probably will pay for? Appealing to insurance repeatedly? Looking for other funding to purchase the Roosevelt ourselves?

The problem with the longer options is his shoulders are pretty much at the top slots of his current seat, so we don't have unlimited time. We might be able to borrow the Nauti out of grampa's car for him for a while, but not sure.

Here's why I'm leery about the Traveller: We only have 2 tether positions in the third row. Third row is not very wide, so I don't know that we can fit it next to the Nauti we have, or the Blvd if we move the Nauti to second row untethered. I was really hoping for the long belt path option on the Roosevelt.

 

ketchupqueen

CPST and ketchup snob

Staff member

• Jan 7, 2010

• #2

You would use the 2 tether anchors for the TP, correct? And then you would have no other tether anchors in the car?

Is it possible for you to put the TP in the third row, and move the Nauti to the second row, then tether the Nauti to a third row seatbelt, if you can't get more tether anchors installed? What vehicle is this, and what year? Can you get another tether anchor put in or is it impossible?

 

M

mama a llama

New member

• Jan 7, 2010

• #3

What? The TP needs both anchors? Oh gosh, then we'd really be sunk. I'm pretty sure the 2 anchors are the only locations allowed by Honda (96 Odyssey). The Nauti is used by my 5 yo, but I don't trust her to be booster ready soon, since she sneakily loosens her harness after we've tightened it. I also have a 2 yo in the Blvd RF. And the other captain's chair is out for a seat, b/c the window is damaged and lets in rain, and we can't afford to fix it right now.

ETA oh I looked up the manual and I see you only need both over 80lbs. He's only 38 now, so would only need one, but eventually that would be a problem, once the 2 yo turns ff.

 

F

flipper68

Senior Community Member

• Jan 7, 2010

• #4

I would appeal but first make some calls to the company (move up the food chain to management). Ask to clarify why the request was denied and what it would take for the company to approve the seat.

The Roosevelt has a higher harness height than the TP and in your situation, the need/desire for multiple top tethers would both be reasons to choose one seat over the other. It could simply be that the insurance company is familar with the TP (we've done that before) and not the Roosevelt (never heard of it).

Do some research on letters of justification and make sure your letter has the 'magic' words that help enable approval. Contact the folks at Merritt for help with this as well since I'm sure they've had families get approval for insurance reimbursement. My PT SIL (lots of practice with letters of justification) says that some insurance companies deny first request almost 100% of the time for almost all pediatric equipment.

 

ketchupqueen

CPST and ketchup snob

Staff member

• Jan 7, 2010

• #5

Ah, third seat in the mix. Gotcha. I agree, try to get them to cover the Roosevelt if that's what you're going to need, tether-wise (though by the time your RFer goes FF I bet your 5 year old will be booster-ready. )

 

M

mama a llama

New member

• Jan 14, 2010

• #6

And, I'm thinking what if they won't approve anything at all, since he's only 4 and hasn't maxed out regular market seats? He's not quite heavy enough to use a 86Y harness with a HBB. Would it make sense to get that setup and put the 5yo in it temporarily and put him in her Nauti? Or better to get him a Nauti or Frontier and get an 86Y when he hits the limits of the seat's harness?

 

ketchupqueen

CPST and ketchup snob

Staff member

• Jan 14, 2010

• #7

Well, the harness is cheaper, long-term, but the Nauti or Frontier might provide more support. HOw much support does he need?

 

M

mama a llama

New member

• Jan 14, 2010

• #8

I'm honestly not sure how much support he needs. He is able to sit on the floor ok, or in a child sized chair, but seems to be uncomfortable sitting in a kitchen chair for instance. And actually my biggest concern with a non 5pt is that he would just slide out the bottom--that would still be an issue with the 86Y, right?

ETA: I'm concerned the Nauti will be too narrow in the shoulders for him longterm, as well.

 

ketchupqueen

CPST and ketchup snob

Staff member

• Jan 14, 2010

• #9

Hmm. I wonder what would happen if you used the 86Y with a PWSG?

 

M

mama a llama

New member

• Jan 14, 2010

• #10

Or, I wonder if Britax is coming out with the SG clip for the Frontier anytime soon. I saw something about that on the review of the PWSG comments.

 

safeinthecar

Moderator - CPS Technician

• Jan 14, 2010

• #11

Chances are the insurance is only going to pay for one seat for him. At his size, I think I would just go with a Regent for now and have the option for the SN seat be available when he has outgrown conventional ones.

Regardless, I'm not sure why the insurance would pay for the TP and not the Roosevelt. They are about the same price.

 

ketchupqueen

CPST and ketchup snob

Staff member

• Jan 14, 2010

• #12

mama a llama said:

Or, I wonder if Britax is coming out with the SG clip for the Frontier anytime soon. I saw something about that on the review of the PWSG comments.

Click to expand...

Yes, I think it may even be available now.