Late last year, a group of Los Angeles attorneys sued United Healthcare, an insurance company, for failing to properly provide coverage for artificial limbs. The lawsuit alleges that the company systematically denies claims for prosthetic arms and legs without assessing or determining the amputee’s needs or how the device will meet those needs.
According to the lawsuit, United has a coverage determination guideline that it uses to deny claims for prosthetic arm and leg devices. The guideline states that if more than one prosthetic device can meet the amputee’s needs, benefits are only available for the device that meets the minimum specifications for the member’s needs. The lawsuit alleges that United has used this guideline to systematically deny coverage for prosthetic arm and leg devices without properly assessing or determining the amputee’s needs.
The lawsuit is asking that the plaintiffs receive compensation from United Healthcare for their claims. The lawsuit also asks that rights to future benefits under the insurance plan be clarified, and that any profits made by the improper denial of claims be retained.
If you are an amputee and you have been denied coverage for a prosthetic device by United Healthcare or by any other insurance company, call me, Conal Doyle, Los Angeles Amputation Attorney at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation on your case.