Policies in health insurance are as rigid as they come, leaving little room for interpretation – or compassion.

However, when an empathetic insurance employee comes across a convenient loophole, they find a way to deliver a rare win for someone in need.

Read on for the full story.

Only processing the claims I’m assigned…

I work at a health insurance company processing claims.

There are a lot of rules and regulations that break my heart. This is my story about one of them.

They explain a particular claim that came across their desk.

A claim is submitted for a Durable Medical Equipment (DME) rental for an oxygen concentrator.

Policy says there is a 36-month rental cap with a 61-month reasonable use cap.

But here’s where the trouble comes in.

This means someone can rent an oxygen concentrator for 3 years and have it covered by insurance.

However, insurance won’t cover another rental until 5 years after the patient started renting the equipment.

So the employee knows what they have to do.

I have been told to work my assigned claims. To only work my assigned claims.

My assigned claim was for month 46 of the rental. This is beyond the 36-month rental cap. I have to deny the claim.

However, there is a loophole they might be able to exploit…

Rental history shows that months 1-36 were covered. Somehow, months 37-44 were also covered.

I had to deny the claim that I was assigned, but I didn’t have to reprocess the history claims that paid “in error.”

I’m not expecting any fallout, but I am sincerely hoping that none of my coworkers look too closely.

The kind actions of this employee provide a small glimmer of hope amid an unjust system.

What did Reddit think?

This commenter offers some dark humor.

This user questions the logic of the entire policy.

For someone who also depends on supplemental oxygen, this story hits extra close to home.

For anyone else needing a similar device, this commenter may have a cheaper workaround.

Here’s to hoping those unnoticed discrepancies will continue quietly working in the patient’s favor.

Now this was a blindspot that actually did some good.

If you liked that story, check out this post about an oblivious CEO who tells a web developer to “act his wage”… and it results in 30% of the workforce being laid off.