Inspiration: Insurance Consultant Helps Client Fight for Life

Have you ever had a personal or professional challenge and felt like there was nowhere to turn? In the darkest moments, is there someone in your corner who gives you the hope and motivation to continue your journey? The creativity, perseverance,  willingness to get involved – these are attributes we hope others see in us and we hopefully have the opportunity and thoughtfulness to put these talents to use for others.

We found this inspirational and thought we’d share (full disclosure: Eric Bertz, whom you’ll meet in a moment, is a long-time business associate of The Wizard). The letter below was written by Eric – a long time financial advisor at, Lincoln Financial Advisors, Boston MA. on behalf of one of his clients.

Here’s the situation: The son of a single mother was accidentally shot and paralyzed on a hot summer night in Worcester, MA.  The type of care he needed to recover was so specialized, it was not covered by insurance. After 3 years of denied claims and insurance company appeals, Eric, in conjunction with the Ray Tye Medical Aid Foundation  came up with an idea worth reading about.

The letter Eric sent to the foundation which tells the story is as follows:

August 10, 2010

Letter to the Ray Tye Medical Aid Foundation on behalf of Lanyia Johnson

I first read about Ray Tye in an obituary published by the Boston Globe on March 11, 2010.  I’m by no means a habitual obituary reader, so I am not entirely certain how I even came upon the article.  My post-reading impression was that it would be impossible not to feel genuinely “taken aback” by the humble attitude Mr. Tye maintained while extending generosity that preserved the health and lives of people facing unimaginable need.  I offer my sincerest thoughts following the loss of a remarkable man, and also, my enthusiastic support for the continued work of the Ray Tye Medical Aid Foundation.  I certainly hope the foundation will preserve Mr. Tye’s charitable nature for many, many years to come.

The reason I felt prompted to write the foundation stems from a similarity I noticed between Mr. Tye’s charitable work and an incident that has troubled me for several years.  I am a financial advisor of 23 years with the Lincoln Financial Group in Boston, and one client I’ve had the pleasure of working with is March Johnson, a single parent living in Worcester.  I am the health insurance advisor to her employer, where she works as the human resources director.  As it is my duty to determine the most cost-effective insurance plan I initially thought I had achieved success when I insured the company  with coverage from Fallon Community Health Care.  However,  Fallon’s lack of consideration for a tragedy that befell the Johnson Family has disheartened me for an unjustly long period of time.  On April 21, 2007, Marcy’s son Lanyia, then 13, was sitting on a couch in his aunt’s home when a stray bullet tore through a window and, after shattering the base of his spine, lodged itself in Lanyia’s right lung.  The bullet remains there to this day.  Lanyia was the innocent victim of a senseless crime, and despite how dismayed we obviously felt in the wake of the crime, we were at least confident that Lanyia’s significant medical expenses  would be covered by the family’s health care plan.

Under Fallon’s guidance, Lanyia endured three different unsuccessful rehabilitation programs.  While the facilities were concentrating on the proper form and execution of a “wheelie”, Lanyia was, naturally, fixated on regaining control in his lower body.  If he would so much as ask when therapy for his legs might begin – and you can bet he asked this pretty frequently – the answers provided by the facility employees soon became morosely predictable.  They always involved the word “impossible”, or one of the many variations on the theme, “you’ll never walk again”.

Despite such overwhelming discouragement, Marcy remained determined to find a positive alternative for Lanyia, and fortunately, she did.  The Johnsons settled on a program called “Journey Forward”, a rehabilitation facility dedicated to using progressive forms of exercise to treat spinal cord injuries.        The program is based in California and with its many success stories, opened a treatment center  in Canton Massachusetts. Several times a week, Marcy must make the several hours’ commute from Worcester for Lanyia’s treatments. The early results of the Journey Forward have been extremely promising.   The treatment provided by Journey Forward extends beyond Lanyia’s desire to regain control of his legs:  the sessions are, in fact, necessary to maintain healthy circulation, proper digestive function, and prevent the loss of bone mass. In addition to the health benefits seen with Lanyia’s enrollment, Marcy and her doctors have reported that Lanyia has overwhelming enthusiasm for the program and its employees.  This represents a crucial departure from the downtrodden spirits that results from the other facilities’ pessimism.

In further support of Lanyia’s continued enrollment in Journey Forward, his primary care physician, and several top specialists from prominent  Boston area hospitals  have written extremely encouraging letters which highlight the substantial physical and emotional progress that Lanyia has experienced at Journey Forward. Since the accident, I have repeatedly challenged Fallon’s refusal to cover even a portion of the treatment.  We have exhausted all our appeals and Fallon’s continued denial of prudent care makes little sense coming from an organization that touts itself as an exemplary corporate citizen.     Marcy’s modest income is the sole source of support for her household, which includes 3 children and a disabled husband.

The story has one truly extraordinary component.  For the other stories of similar nature that I have read about, I have never seen anything like this.  I am talking about Lanyia’s capacity for forgiveness.  When Lanyia appeared in the Worcester, MA courtroom where Shawn F. Sims, the man convicted of firing the stray bullet that shattered Lanyia’s spine, sat on trial, Lanyia’s statements were astonishing in their complete optimism and utter lack of any lingering “negative” emotion.  He told the courtroom that his paralysis was a God-given challenge, before asserting, “And I overcome challenges… I’m going to walk again”.  He then turned his wheelchair to the man who turned his life upside down and looked him in the eyes before he was able to say…”I don’t hate you.  I’m a forgiving person.  I forgive you.” Nothing could be more telling of Lanyia’s exceptional character, and it certainly prompted me to wonder: what part of Lanyia’s upbringing cultivated his personality to the extent he could alleviate any and all resentment? Lanyia’s  example will serve as one of the most memorable and admirable I have had the fortune to encounter in my personal and professional life.

I am writing this letter on a personal and individual basis – I have chronicled the Johnson’s misfortunes and have done all in my power to negotiate with Fallon in the vain hope that they could find some way to aid a struggling family in the own health-care community.  With the Johnson family household income below the federal poverty level guideline, the family simply cannot afford to continue work with Journey Forward.  Despite my efforts being ultimately unsuccessful, I am following Lanyia’s example by remaining optimistic that there will be an alternative way to help the Johnson family.  The article about the life work of Ray Tye made me think it would be entirely worthwhile to write the foundation for their consideration on behalf of the Johnson family.  Mr Tye was quoted as saying, “When you save a life, you save a future”, and I have no doubt that this is one life worth saving.

I thank you graciously for taking the time to read this lengthy letter and I hope you share my enthusiasm for Lanyia’s rehabilitation.

Respectfully,

Eric Bertz

The good news is it worked! The Ray Tye Medical Aid Foundation came through and Laniya got his treatment.

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