Patients Turn to Sheer Health to Fight Insurance Claim Denials

A new company aims to take on the battle with insurers over denied medical treatments and procedures.

Apr. 12, 2026 at 1:41pm

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A ghostly, translucent X-ray image of a human spine, with the vertebrae and discs glowing against a dark background, conceptually representing the medical challenges faced by a patient struggling to get insurance coverage for necessary treatment.An X-ray view of a patient's spine reveals the internal damage that insurance companies often fail to recognize when denying coverage for necessary medical procedures.Princeton Today

Mathew Evins, a marketing executive, struggled for seven months to get his insurance company to approve back surgery that his doctors said was necessary. After exhausting non-invasive treatments, Evins' insurance company repeatedly denied coverage, forcing him to undergo additional physical therapy. Seventy-three percent of Americans say delays and denials of medical treatment by healthcare insurers are a major problem. Now, a company called Sheer Health says they will fight insurance battles on behalf of patients for a monthly fee or a percentage of any money recovered.

Why it matters

This case highlights the ongoing challenges many Americans face in getting their health insurance companies to approve necessary medical treatments. With 27 million Americans lacking health insurance altogether, those who do have coverage often find themselves in battles with their insurers over coverage decisions that can have serious impacts on their health and well-being.

The details

Evins had exhausted non-invasive treatment options for his chronic back pain and his doctors agreed he needed surgery. However, his insurance company denied coverage, first requiring him to undergo an additional six weeks of physical therapy. Even after that, they denied coverage again, and it took seven months before Evins was finally able to get the surgery approved. During that time, his condition deteriorated. Sheer Health reviewed Evins' policy, submitted an expedited appeal, and worked with his doctor to get the authorization issue resolved, allowing Evins to finally have the surgery in October.

  • In 2024, Evins had trouble just walking due to his chronic back pain.
  • After his initial denial, Evins reluctantly complied with six more weeks of physical therapy.
  • Even after the additional therapy, Evins' insurance denied coverage again.
  • It took seven months before Evins was finally able to get the surgery approved.
  • Evins had the back surgery in mid-October.

The players

Mathew Evins

A marketing executive who lived with chronic back pain for eight years and struggled to get his insurance company to approve necessary surgery.

Sheer Health

A company that fights insurance battles on behalf of patients for a monthly fee or a percentage of any money recovered.

Katherine Hempstead

A senior policy officer at the Robert Wood Johnson Foundation who has seen many cases of patients struggling to get insurance coverage for needed medical treatments.

Jeff Witten

The co-founder of Sheer Health, a company that aims to handle insurance battles for patients.

Ben Howard

The co-founder of Sheer Health, a company that aims to handle insurance battles for patients.

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What they’re saying

“Emotionally, it's like a roller coaster. Physically, I just wanted relief.”

— Mathew Evins

“It's not the case that the providers are the angels and the insurance companies are the devils. I mean, we could do another show about hospital pricing. But I think that consumers feel like, 'Hey, doctors are actually doing something. They're trying to do something that they say will help me. And here is this intermediary coming in and saying that they can't do it.'”

— Katherine Hempstead, Senior Policy Officer, Robert Wood Johnson Foundation

“Our goal is for people to never have to deal with their health insurance again.”

— Ben Howard, Co-founder, Sheer Health

“It's people's lives that these insurance companies hold in the balance. Take that seriously. You're not their medical practitioner. Don't act like it.”

— Mathew Evins

What’s next

Sheer Health plans to continue expanding its services to help more patients fight insurance claim denials and delays, with the goal of reducing the burden on individuals and improving access to necessary medical care.

The takeaway

This case highlights the ongoing struggles many Americans face in navigating the complex and often adversarial relationship between patients, healthcare providers, and insurance companies. While companies like Sheer Health offer a potential solution, the broader issue points to the need for systemic reforms to ensure that healthcare decisions are driven by medical necessity rather than financial considerations.