Late last year, two customers of Blue Shield sued the company, alleging that it wrongfully failed to pay for microprocessor-controlled prosthetic limbs. The lawsuit alleges that the company wrongfully claimed that the limbs are not medically necessary and are investigational. Blue Shield pays for the cheaper limbs, which are body-controlled.
The lawsuit lays out in detail the benefits of microprocessor-controlled limbs for people with lower limb loss in ordinary settings. Some of the benefits of microprocessor foot prostheses include:
- They respond to constant feedback. This helps the foot change resistance to downward and upward motion in real time.
- They reduce toe drag, which helps with balance.
- They create stability for the user, which decreases stumbles and falls.
- They improve ambulation on all surfaces.
- They decrease the discomfort and pain caused by a prosthetic device.
According to the lawsuit, these benefits have all been proven by scientific studies. The lawsuit also alleges that these devices have been accepted by the medical community for years. However, Blue Shield still claims that the devices are investigational and not medically necessary.
If you are suffering from limb loss, and your insurance company refuses to pay for your prosthetic limb, you should speak with an attorney. Call me, Conal Doyle, at 310-385-0567. I’m currently involved in several lawsuits against insurance companies and will be happy to speak with you. Call today to learn more or to schedule a free consultation on your case.