Tore my achilles tendon, doc needed to do an MRI. Insurance company wouldn't authorize an MRI without an xray first even though literally everyone else knew they don't show up on xrays.
Always nice to have to go through months of PT that you, your doctor and your therapist know aren't going to help, but you're forced to jump through hoops to get those fucking ghouls to authorize it.
Insurance companies in the US often exhibit paradoxical behavior based entirely on statistics and ignoring individual case details.
Often a less expensive procedure will be denied until after a more expensive procedure is performed, guaranteeing that insurance has to pay for both, just because some significant percent of patients need the more expensive procedure either way.
Health insurance is utterly stupid, and mainly because it's a for-profit, private enterprise in the US. Data goes in and a decision comes out, and the insurance companies really only care as long as the algorithm results in a net profit over time. Good outcomes for patients isn't even a consideration.