Two individuals suffering from limb loss are suing Blue Shield for damages for its failure to pay for prostheses. The men were customers of Blue Shield who made claims for prostheses under the terms of their insurance plans. The company denied the claim of one of the plaintiffs and paid only a portion of the cost of the prosthesis for the other plaintiff.
The plaintiffs are seeking to turn the lawsuit into a class action in order to help the other customers of Blue Shield who have had their claims for prostheses denied by the company. The lawsuit is seeking to certify two classes of individuals:
- People covered under Blue Shield of California non-ERISA health plans whose requests for microprocessor-controlled foot prostheses have been or will be denied as “investigational”; and
- People covered under Blue Shield of California non-ERISA health plans whose requests for prosthetic lower limbs were paid by Blue Shield to out-of-network providers during the applicable statute of limitation.
The lawsuit claims that the proposed classes meet the requirements of a certified class because there are such a large number of members, the members can be ascertained, there are issues common to all class members, the plaintiffs have claims typical of members of the class, the plaintiffs will fairly protect the interests of the class members, Blue Shield has acted or refused to act in a manner similar to all class members, and that a class action would be the best way to handle the case.
If you have had claims for a prosthetic limb denied by Blue Shield, call me, Conal Doyle, California personal injury attorney at 310-385-0567. My team can help. Call today to learn more or to schedule a free consultation.