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 not investigational and that they provide significant benefits over mechanical feet. The second claim is that the company failed to develop a network of prosthetists, resulting in many amputees being forced to use out-of-network prosthetists, resulting in large out-of-pocket expenses to them.
The lawsuit is seeking certification of two classes. The first is all people covered under Blue Shield of California whose requests for microprocessor-controlled foot prostheses have been or will be denied as “investigational”. The second is all people covered under Blue Shield of California whose requests for prosthetic limbs were paid to out-of-network providers.
If you believe that your claim for a prosthetic limb was incorrectly handled by Blue Shield of California, call me, Conal Doyle, California amputation attorney, at 310-385-0567. My team can help. Call today to learn more or to schedule a free consultation on your case.