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Lawsuit Claims that United Healthcare Violated Federal ERISA Law

A lawsuit that was filed late last year on behalf of two individuals suffering from limb loss claims that United Healthcare, an insurance company, violated federal law by refusing to pay for some prosthetic limbs. The lawsuit is seeking to be certified as a class action. The lawsuit alleges that United systematically refused all requests for some prosthetic limbs without any investigation into those requests. Instead, the company simply issued blanket denials without assessing the member’s needs or whether the requested device was necessary. The lawsuit alleges that the company violated federal law because it acts as a federal fiduciary …

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Lawsuit Filed Against Insurance Companies for Failing to Cover Prosthetic Limbs Seeks to be a Class Action

If you are an amputee or are suffering from limb loss, and your insurance company denied coverage for a prosthetic limb, you may be eligible to join a lawsuit against the insurance company. Currently, several lawsuits are underway against insurance companies, including United Healthcare, Blue Shield, and Anthem, for their failure to cover prosthetic limbs. The lawsuits that are currently underway all allege that the insurance companies are refusing to pay for certain types of prosthetic limbs, microprocessor-controlled prosthetic limbs. Microprocessor-controlled limbs used computers and sensors to control the limb instead of just the body. They are more complex than …

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United Healthcare Sued for Refusing to Pay for Myoelectric Prosthetic Arms

United Healthcare was sued late last year for several causes of action related to prosthetic limbs and their refusal to pay for some prosthetic limbs for their customers. Two amputees filed a lawsuit against the company, claiming its practices are in violation of law. One of the lawsuit’s claims is that United wrongfully refuses to pay for myolectric arms. Myoelectric arms are a type of upper limb prosthetic device which can be used to replace the essential functions of the arm, hand, wrist, and elbow. According to the lawsuit, by the 1980s myoelectric arms were being used in rehab centers …

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Blue Shield Accused of Underpaying for Prosthetic Leg Components

A lawsuit that was filed against Blue Shield, the health insurance company, accuses it of wrongful practices in regard to paying for prosthetic limbs. The lawsuit was filed by two amputees whose claims for prosthetic limbs were not properly compensated by Blue Shield. The lawsuit is seeking to become a class action lawsuit so that other amputees who were similarly affected can join. The lawsuit alleges several ways in which Blue Shield wrongfully avoids paying for expensive prosthetic limbs. Among the claims in the lawsuit is that Blue Shield purposely underpays for prosthetic leg components if those components have been …

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Anthem Insurance Accused of Using Faulty Criteria to Reject Claims for Prosthetics

Two amputees recently sued the Anthem insurance company, claiming that the insurance company wrongfully denied their claims for prosthetic limbs. The company refuses to cover limbs that are not “medically necessary”. The requested limbs were microprocessor-controlled limbs, or limbs that are powered by sensors and an onboard computer. The plaintiffs both requested that Anthem cover their microprocessor-controlled limbs, which Anthem refused to cover. According to its policies, Anthem does not cover services that are not “medically necessary”. The company has a list of criteria that a service must meet in order to be considered “medically necessary”. One of those criteria …

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Lawsuit Claims that Blue Shield Denies Benefits of Computerized Foot Prostheses

A lawsuit was filed in November of last year against Blue Shield, the health insurance company, for its failure to pay for certain types of prosthetic feet for its members. The lawsuit alleges that Blue Shield ignores the numerous benefits of these prostheses, and wrongly labels them as investigational. The lawsuit specifically refers to microprocessor-controlled foot prostheses. These prosthetic feet respond to constant feedback from sensors embedded in the feet to the onboard computer. The computer than changes the resistance to downward motion and upward motion of the foot based on walking speed, incline, decline, and the type of terrain …

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Two Amputees Sue United Healthcare, Ask Lawsuit Become Class Action

In December of last year, two individuals suffering from limb loss sued United Healthcare over its failure to cover certain types of prosthetic limbs. The plaintiffs had their claims for prostheses denied on the basis that the requested limb is not the most basic limb that will meet the individual’s needs. The amputees sued United Healthcare, claiming that it failed to investigate the situations, and instead simply issued a blanket denial of coverage. The lawsuit claims that United did not assess or determine their functional needs, the minimum limbs that would meet those needs, and failed to identify any alternative …

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United Healthcare Accused of Denying All Claims for Some Prosthetic Limbs without Investigation

United Healthcare, a health insurance company, was sued late last year by two individuals suffering from limb loss. The lawsuit alleges that the company issues blanket denials for some types of prosthetic limbs without any type of investigation into whether the limb is needed for the situation. The plaintiffs are seeking to turn the lawsuit into a class action so that other amputees can join the lawsuit. According to the lawsuit, United has guidelines that determine whether or not certain devices and services are covered under its insurance policies. The guidelines for prosthetic limbs state that “If more than one …

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Amputees Sue Blue Shield for Small Network of Prosthetists

Two amputees sued Blue Shield, alleging that the company’s policies on payment for prosthetic limbs are in violation of its contractual promises. The amputees are seeking to force Blue Shield to change its policies, as well as to receive compensation for their damages. One of the amputees underwent a leg amputation in 2009 after a car accident. In 2015, he sought help for the problems he was having with his existing prosthetic limb. Under the terms of his insurance policy with Blue Shield, he was required to use an in-network prosthetist in order for the device to be covered. He …

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Insurance Companies Sued for Denying Computerized Prostheses to Amputees; Lawsuits may Become Class Actions

Late last year, amputees sued three insurance companies for their failure to provide computerized prostheses to their customers. The plaintiffs in the cases are seeking to turn the lawsuits into class actions. The insurance companies that were sued are Anthem, United Healthcare, and Blue Shield. The lawsuits were filed in California. Each lawsuit was filed by two individuals suffering from limb loss, whose claims for microprocessor-controlled prostheses were denied. The lawsuits allege that the companies offered various justifications for why the prostheses are not necessary, such as claiming that they are “investigational”, “not medically necessary”, or that other, less expensive …

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Anthem Insurance Company Sued for Denying All Claims for Computerized Foot-Ankle Prosthetics

Two individuals suffering from limb loss have sued the Anthem Insurance Company for its failure to provide prostheses for its customers. Among other allegations contained in the lawsuit is the claim that the company denied claims for all microprocessor-controlled foot ankle prostheses. The company has labeled them as investigational and not medically necessary for all indications. The lawsuit claims that microprocessor-controlled foot-ankle devices use technology to simulate the movements of a normal foot and ankle. The device responds to constant feedback from sensors to the microprocessor, which changes the downward and upward motion of the foot based on walking speed, …

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United Healthcare Denies Claim for Prosthesis for 12-Year-Old Boy

A lawsuit is currently underway against United Healthcare for its failure to pay for prosthetic limbs for some of its customers. One of the customers who is currently involved in the lawsuit is a 12-year-old-boy suffering from limb loss. The plaintiffs are seeking to turn the lawsuit into a class action. The boy was covered under his mother’s insurance plan issued by United Healthcare. He suffers from a congenitally-acquired absence of the right forearm. As he has grown, he has required new prosthetic devices to fit his body. His prosthetic forearm and hand help him to perform everyday functions such …

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