From Catastrophe to Court

By David S. Hilzenrath
Washington Post Staff Writer
Sunday, February 28, 1999; 8:54 PM

She was asleep in the passenger seat when the car carrying her back to a New Hampshire prep school in the fall of 1992 veered off the highway, plunged down an embankment and slammed into a tree. For a moment, the tiny teenager with the outsized intellect appeared to be untouched. The hired driver thought she had slept through the crash. Then a drop of blood dripped from her nose, hinting at the true devastation.

Alistaire Moore was in a coma, a victim of severe brain damage. In the awful days that followed, doctors at a New York hospital advised her parents William and Judith Moore to disconnect life support and donate Alistaire's organs.

But the Moores refused to let go.

After 45 days, Alistaire emerged from her vegetative state--unable to talk, or walk or sit up in a chair, let alone dress and feed herself.

Today, at age 21, Alistaire is a student at Towson University, struggling with impairments but living a normal life.

That she has come this far is remarkable. But there was more to the battle. Bill and Judy Moore are suing their health insurer for hundreds of thousands of dollars, trying to recoup what they spent to bring Alistaire back.

The Silver Spring couple contends that Blue Cross and Blue Shield of the National Capital Area abandoned them during Alistaire's long and difficult rehabilitation and should pay for an extensive array of treatment they funded on their own--$433,684.88.

The tally includes tutoring in physics, math and French, along with fitness training and karate lessons. It includes two years at Phillips Exeter Academy, the elite New Hampshire prep school, plus travel and lodging there for Alistaire's mother. It includes a laptop computer, with accessories. And it includes thousands of hours that the Moores devoted to their daughter's care, time they value at $291,003.

The Moores' dedication to Alistaire's recovery is beyond dispute. The question for the judge is: Who should pay the bill?

The case of William Moore, et al. v. CapitalCare Inc. is about a family going to extraordinary lengths to overcome a medical catastrophe, but that's just the beginning.

As Blue Cross's CapitalCare HMO tells it, the case is about parents who took charge of their daughter's treatment, ignored the terms of their insurance coverage, and demanded their health plan pay the bills regardless.

As the Moores tell it, the case is about an HMO that would sooner sacrifice their daughter's recovery than spend money, a corporate bureaucracy that used a strategy of delay, deny and dodge to avoid its obligations.

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