Late last year, three insurance companies operating in California were sued for their failure to cover certain types of artificial limbs. The three insurance companies are Blue Shield, Anthem, and United Healthcare. According to the lawsuits, the three companies all have improperly denied claims for microprocessor-controlled lower limbs for customers who are suffering from limb loss.
The lawsuits are all different, but all allege that the insurance companies regularly deny coverage for some artificial limbs for their customers. The insurance companies often refuse to pay for microprocessor-controlled limbs, and instead only pay for body-powered artificial limbs. Microprocessor-controlled limbs use computer chips to adjust settings for their users based on feedback from the limb. Those limbs are typically more expensive, but provide a number of huge benefits for the users.
The insurance companies have been denying coverage for the limbs for several reasons. They claim that the limbs are investigational, not medically necessary, or not the most basic limb that will meet the user’s needs. One company was sued for failing to maintain an appropriate network of prosthetists, resulting in huge fees for its customers suffering from limb loss.
Call me, Conal Doyle, Los Angeles personal injury attorney at 310-385-0567 if you have suffered from limb loss and your insurance company refused to pay for the appropriate limb for you. My team can help.