Two individuals who suffered limb loss recently sued Blue Shield of California, claiming their prostheses were not properly covered under the terms of the insurance policies. One member had his claim for a microprocessor-controlled prosthesis denied by the company. The other member had to use an out-of-network prosthetist and had to pay extensive out-of-pocket costs due to the lack of availability of in-network prosthetists.
Those two individuals sued Blue Shield and are seeking to make the lawsuit a class action lawsuit. In the case, the plaintiffs are asking that Blue Shield be forced by the court to take five actions. They are: 1. Stop its practice of denying all requests for microprocessor-controlled foot prostheses; 2. Notify class members that its decision to categorically deny all requests was incorrect and that all previously denied requests will be re-reviewed; 3. Re-review all previously denied requests for microprocessor-controlled foot prostheses in a proper manner; 4. Notify class members that if they have paid out-of-pocket for denied microprocessor-controlled foot prostheses, they can submit those claims for review; and 5. Review any such claims received in a proper manner.
If you have suffered from limb loss, and Blue Shield of California failed to pay for your prosthetic limb, call me, Conal Doyle, Los Angeles personal injury attorney, at 310-385-0567. My team can help. Call today to schedule your free consultation.