"And therefore, someone must decide what claims are reasonable."

Yes, that person is MY DOCTOR. There is no world in which it is reasonable that my health care team says I should have particular treatment, and insurance executives get to say no I don't. Sadly I understand this is not the case, and we value money more than human life, but I do not find that reasonable, no matter how common it might be.

I also understand that medical fraud happens, but I'm not sure the tradeoff to reducing it is worth the lives it's taking when we refuse claims.