Blue Shield of California Sued for Failing to Properly Reimburse Prosthetists

A lawsuit that was filed late last year accuses Blue Shield of California of refusing to properly reimburse prosthetists for their prosthetic leg components. The lawsuit is seeking restitution and damages for the victims, as well as an injunction against Blue Shield’s business practices.

Under Blue Shield’s insurance contract with its customers, the insurance policy is designed for customers to obtain services from in-network medical professionals. If the customer chooses to get an out-of-network provider, the costs to the customer are usually higher. According to the lawsuit, implicit in the contract is the promise that Blue Shield will maintain a good network of providers. However, Blue Shield has failed to maintain an adequate network of prosthetists, which can result in customers being forced to obtain treatment from out-of-network prosthetists.

In the lawsuit, one amputee (who was a customer of Blue Shield of California) is alleged to have been unable to find an in-network prosthetist to create a below the knee artificial limb. The amputee was forced to use an out-of-network prosthetist. Blue Shield only paid 37 percent of the cost of the limb, which forced the amputee to pay about $18,000 out of pocket.

If you are an amputee and a customer of Blue Shield of California, and you have been forced to use an out-of-network prosthetist, which resulted in high expenses to you, call me, Conal Doyle, Los Angeles personal injury attorney at 310-385-0567. I can help you to join the class action lawsuit. Call today to learn more or to schedule a free consultation on your case.