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Anthem, a health insurance company, has been sued by two of its members who are suffering from limb loss. They claim that Anthem failed to properly pay their claims for prosthetic limbs. They are seeking to turn their lawsuit into a class action lawsuit so that others who were similarly affected can join the lawsuit. They are also asking that the company be required to change its policies going forward, and to compensate them for their artificial limbs. Anthem has labeled certain types of prostheses as “investigational” in some of its claim denials. The limbs they label as investigational are …

Two individuals suffering from limb loss have sued United Healthcare, claiming that the company’s policies with respect to coverage for artificial limbs are in violation of the law. The lawsuit is asking that United be required to change its policies going forward with respect to coverage for artificial limbs. The company is accused of issuing blanket denials for some types of prosthetic limbs without property assessing the individual’s needs, what device will best meet those needs, and which alternative prosthetic devices will meet the individual’s needs. The lawsuit is asking that the company be required to change its policies going …

Two amputees sued Blue Shield of California, a health insurance company. The amputees claim that Blue Shield has been acting in bad faith in its practices in compensating members for their artificial limbs. The lawsuit is seeking to be certified as a class action, meaning that others who have been similarly affected by Blue Shield will be eligible to join the lawsuit. Specifically, the amputees have two claims. First, they claim that the company wrongfully denies all claims for microprocessor-controlled foot prostheses. The company claims that the limbs are investigational. The lawsuit alleges that studies show that the limbs are …

A married mother of five sued Anthem, a health insurance company, for its failure to pay for her prosthetic leg. She claims that the company is acting in bad faith in denying her request. The woman was diagnosed with a cancerous tumor in her left leg when she was 11. Her leg was amputated above the knee, and she was fitted with a prosthesis. She now has five children. In 2016, she was referred to a prosthetist who determined she needed a prosthetic leg with a microprocessor-controlled knee. The prosthetist sought authorization from Anthem for the device. Anthem denied coverage, …

Two individuals suffering from limb loss sued Blue Shield, the health insurance company, last year. The amputees are claiming that Blue Shield violated the terms of its health insurance policies in two ways. First, the company categorically denies all requests for some types of lower limb prostheses. The lawsuit also alleges that the company does not maintain an appropriate network of prosthetists, which forces many customers to seek services from out-of-network providers. The lawsuit is asking that the company be required to change its policies, as well as to reimburse the plaintiffs for their expenses. The plaintiffs are seeking to …

Late last year, three lawsuits were filed against major health insurance companies in California for their failure to pay for prosthetic limbs. The insurance companies that were sued are Anthem, Blue Shield, and United Healthcare. All three lawsuits were filed by amputees whose requests for prosthetic devices were denied. The lawsuits are ongoing and all are asking to be certified as class action lawsuits. In all three lawsuits, the plaintiffs allege that the insurance companies failed to pay for their prosthetic limbs. The requested limbs were microprocessor-controlled limbs, which are prosthetic limbs that use sensors, computer chips, and a computer …

In December of 2017, United Healthcare, the health insurance company, was sued by two amputees. The lawsuit alleges that the company violated its own policies by refusing requests for some prosthetic devices without an investigation into the requested device. The amputees are asking that the lawsuit be certified as a class action and that the company be forced to change its policies going forward. According to the terms of the insurance contract, “If more than one prosthetic device can meet the member’s functional needs, benefits are only available for the prosthetic device that meets the minimum specifications for the member’s …

Anthem, the health insurance company, was sued last year by two individuals suffering from limb loss. They sued Anthem for its failure to provide microprocessor-controlled prosthetic devices, which are devices controlled by computer chips. Instead, the company will only cover body-powered devices. The lawsuit is seeking to be certified as a class action lawsuit so that others who are similarly affected can join. According to the lawsuit, Anthem incorrectly denies requests for microprocessor knee prostheses. Anthem has deemed requests for those devices as “not medically necessary” unless the following criteria are met: The individual has adequate cardiovascular reserve and cognitive …

A lawsuit that was filed last year alleges that Blue Shield, a health insurance company, has wrongfully denied claims for some types of prosthetic feet. The lawsuit was filed by two customers of Blue Shield whose claims for prosthetic limbs have been denied. The lawsuit is ongoing. The lawsuit claims that Blue Shield routinely denies requests for microprocessor-controlled prosthetic feet. Microprocessor-controlled feet are prosthetic feet that are powered by microprocessors instead of by the human body. The company has developed and implemented a written medical policy called “Microprocessor-Controlled Prostheses for the Lower Limb”. The policy says that Blue Shield considers …

Three major insurance companies, Anthem, United, and Blue Shield, have recently been sued for their failure to pay for prosthetic limbs for their customers. Each of the lawsuits was filed late last year, and all three lawsuits are seeking to be certified as a class action lawsuit. The lawsuits, while all slightly different, all claim that the insurance company wrongfully refused to pay for a microprocessor-controlled prosthetic limb. Microprocessor-controlled prostheses use computers and sensors and can react in real-time to help the user with stability, dexterity, and many other benefits. The other alternative is body-powered limbs, which are normally more …

Anthem, a health insurance company, has been sued for its failure to pay for some artificial limbs for its customers who are suffering from limb loss. Anthem, as well as other insurance companies, has refused to pay for some computerized artificial limbs. Those limbs are more expensive than other, more basic limbs. According to the lawsuit, Anthem has made a number of claims for why those prostheses are not covered. One of the allegations is that microprocessor-controlled limbs (or computerized limbs) are primarily for athletic endeavors, not for normal activities of daily living. However, the lawsuit alleges that the primary …

Blue Shield, the health insurance company, was sued in November last year by two customers. The customers are suffering from limb loss and sought prosthetic devices under the terms of their health insurance policies. After failing to get the requested devices, the customers decided to sue. They are seeking to turn the lawsuit into a class action lawsuit and are seeking others who have been similarly affected by the company’s policies. Blue Shield has been accused of denying coverage for microprocessor-controlled foot prostheses. These are limbs which contain sensors and a computer. The sensors send signals to the computer, which …