I am an amputee and my insurance company refuses to pay for a C-leg. Can I sue the insurance company?

As an amputee as well as a personal injury attorney, I understand how frustrating dealing with insurance companies can be. Unfortunately, many insurance companies are very happy to collect customers’ premiums, but when the time comes to pay claims, they may refuse to pay. The biggest reasons insurance companies use when denying claims is that the medical claims are not medically necessary or are experimental, both of which are typically excluded under insurance policies.

A C-leg refers to a type of prosthetic leg that has a microprocessor knee. The C-leg is manufactured by Ottobock, and is more expensive than other types of prosthetic legs. It is also more advanced, and offers a lot of benefits that are not available to users of other types of prosthetic legs. The C-leg is more stable than other prosthetics, and can adapt to users and the manner in which they walk. It can also make walking backwards much easier.

If your insurance company refuses to pay for a C-leg, your first step is to check your policy, as well as talking to your doctor and your prosthetist. Getting coverage may be as simple as getting additional documentation from a doctor. However, in some cases obtaining coverage involves a fight with the insurance company. Many insurance companies act in bad faith, and could be required to pay for not only your prosthetic leg, but also your attorney’s fees.

Call me, Conal Doyle, Amputation Attorney, if you have been denied coverage of a prosthetic leg to which you believe you are entitled. I can help. Call today at 310-385-0567 to learn more or to schedule a free consultation on your case.