Anthem, a health insurance company, was recently sued in a class action lawsuit. The plaintiffs are individuals suffering from limb loss who had their claims for prosthetic limbs denied by Anthem. The plaintiffs are seeking to find other individuals whose claims have been denied by Anthem in order to proceed as a class action.
According to the lawsuit, when a customer of Anthem requests a microprocessor-controlled knee prosthesis, Anthem denies the request on the basis that the knee is not medically necessary. The plaintiffs claim that the devices are effective and necessary for people with lower limb loss.
Microprocessor-controlled knees have sensors, microprocessors, software, a battery, and a resistance system. The knee has a computer which controls internal fluid. The computer uses sensors to monitor each phase of a user’s gait cycle. Based on the feedback, the computer adjusts the resistance to knee bending and straightening to accommodate walking speed and terrain, which can enhance stability for the user, decrease falls, and provide other benefits. Microprocessor knees are primarily for walking around, not engaging in athletics.
As you might imagine, microprocessor-controlled knees are more expensive than other, less sophisticated types of limbs. If you have suffered from limb loss and Anthem or another insurance company has refused to provide you with the limb you need, call me, Conal Doyle, Amputation Attorney, at 310-385-0567. Currently, my team is working on several lawsuits against insurance companies for their failure to provide proper coverage for prosthetic limbs. Call today to learn more.