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 advantages of microprocessor limbs are safety and stability for the user. Standard microprocessor limbs dot not help with speed or ability to engage in athletic endeavors. The lawsuit claims that there are other, very different types of prosthetics whose purpose is to help with sports.
The lawsuit claims that microprocessor limbs are simply used to help simulate the movements of normal limbs. They respond to feedback from the sensors to the microprocessor, which changes the downward and upward motion of the limb based on a number of factors. According to the lawsuit, these devices are established and accepted by the medical community as “standard” prostheses and are routinely prescribed for people meeting certain criteria.
If you are an amputee and you have had your claim for a prosthesis denied, you should speak with an attorney. Call me, Conal Doyle, personal injury attorney, at 310-385-0567. I am currently involved in several lawsuits against insurance companies and I can help. Call today to learn more or to schedule a free consultation on your case.