An Orem couple whose 9-year-old daughter suffers from a rare digestive disorder has filed a federal suit to get their health-care provider to pay for the nutritional formula they need to keep their daughter healthy.
Dallyn and Tammy Zundel say their daughter, Ashley, suffers from a rare digestive disorder known as eosinophilic gastroenteritis. Doctors say the condition prevents Ashley from being able to digest an array of foods.
The parents say when she was younger, Ashley could eat only rice, rice milk, potatoes, turkey and apple juice without suffering from severe diarrhea, stomachaches, headaches, sore throats and throat constrictions. Eventually, even those foods became difficult for her to digest, and she is now at the point where she cannot eat any food at all, except for ice and sugar water.
The Zundels say they have been forced to feed Ashley a nutritional formula that is administered through a feeding tube in her nose or abdomen. This formula prevents her from becoming malnourished.
According to their suit filed Wednesday in U.S. District Court, the Zundels submitted claims to the father's health insurance company, Blue Cross Blue Shield of North Carolina, to help cover the cost of the formula, which is about $950 each month. To convince the company that the formula was necessary they submitted medical records and doctors' opinions about their need.
The Zundels say BCBS denied their claim, asserting that the formula is not covered under their plan and is considered a nutritional supplement.
The formula, the Zundels claim, is a prescribed medication they say is necessary to save their daughter's life.
After exhausting their appeal options with BCBS, the parents say they filed their suit.
BCBS spokeswoman Heidi Deja said her company has no comment at this time.
The couple is also suing Dallyn Zundel's employer, Dex Media Inc., a division of R.H. Donnelly Company, which provides the insurance coverage.
E-mail: [email protected]