Being denied proper healthcare can leave you feeling hopeless. If you believe your health plan is wrong and delay could be harmful, provide care first and then hold the health plan accountable. Your luck is better when you’re alive.

News rejections occur with alarming frequency every day, but only a few make the news. A recent decision by the Hawaii Supreme Court shed light on the problem. News makes us aware of threats and how to avoid them.

So what should you do when you’re denied coverage for a medically necessary treatment or diagnostic procedure like an MRI?

First of all, do not leave your authority to the health insurer. If your doctor believes that you should receive treatment without delay, get the treatment and then appeal the rejection decision.

Here’s a concrete example from a grandfather I know: A health insurance company was deciding whether to approve emergency treatment for his grandchild, who was potentially fatal for a previously diagnosed birth defect. Grandpa sat with him in the emergency room for a terrifying hour. When the grandfather believed he could wait no longer, he picked up his grandson and rushed to another nearby emergency room; Here his grandson was immediately treated and survived. The health insurance company was eventually ordered to pay the emergency room’s $25,000 bill, plus attorney fees.

Be your own grandfather. If your treatment is successful, your doctor may be able to support your appeal with better evidence. If your health insurer and doctor cannot have a productive conversation after this, you are in a good position to pursue legal action with your claim.

Doctors are your best front-line advocates because they know their patients and their medical needs better than non-medical provider health insurers. For many years, health insurers have spread suspicions that doctors prescribe unnecessary treatments whenever they can. The claim is not supported by evidence.

Then we are faced with the issue of “managed care.” With managed care, the insurance company, not your doctor, is responsible for your health. Instead of working independently and billing multiple competing insurance companies, your doctor shares his or her financial interests with a single insurance company. There is good routine medicine practiced in the managed care model, but the sharing of financial interests with the insurance company results in medical decision making in the face of expensive treatment or equipment costs, inadequate staff to support treatment, or the need to refer to unaffiliated specialists or special qualifications. Transfer to a private facility.

If you find yourself literally fighting for your life, paying for care yourself may be your only option. You may undergo a diagnostic procedure or even expensive treatment or therapy. If the diagnostic procedure finds something that would not have been found without it, or if the treatment is successful, this can be important evidence that the denial of the health plan was wrong. There have been cases where courts have ordered health plans to retroactively reimburse members who chose to pursue treatment contrary to the health plan’s position, as in grandfathering, because delaying or accepting treatment was clearly not the right choice.

We must refuse to die or become disabled; Stand firm and use the rule of law to counter powerful opponents. When it’s a matter of life or death, choose life.

Rafael del Castillo is a Honolulu-based attorney who represents numerous patients in health insurance claims.