A correction to an earlier version of this article has been appended to the end of the article.

Health insurance giant Anthem wanted $1,800 from Lauren Gonzalves for hospital nursery services after the birth of her son. But it had been two years since the Concord mother gave birth, she had already paid her out-of-pocket maximum and she believed her policy covered the care for which Anthem repeatedly sought payment.

The situation may be unsurprising for many of those with health insurance. Health care consultancy Premier pegged the national medical claims denial rate at 15% in 2023, while independent research group KFF found insurers that sell policies under the Affordable Care Act denied one in five claims that year .

Gonzalves, however, had an advantage over many policyholders: She

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