A lawsuit was filed last year against Blue Shield of California for its failure to properly pay for some prosthetic limbs, as well as for its failure to build up a network of providers who can make prosthetic limbs. The plaintiffs are seeking compensation for their losses, as well as to certify the lawsuit as a class action.
Specifically, the plaintiffs are seeking for two classes of individuals to be certified:
- All persons covered under Blue Shield of California non-ERISA health plans whose request for microprocessor-controlled foot prostheses have been or will be denied during the applicable statute of limitations as “investigational”; and
- All persons covered under Blue Shield of California non-ERISA health plans whose requests for prosthetic lower limb devices were paid by Blue Shield to out-of-network providers during the applicable statute of limitations.
According to the lawsuit, Blue Shield of California has wrongfully claimed that microprocessor-controlled foot prostheses are investigational and therefore not covered under the insurance plans. However, the lawsuit alleges that these types of prostheses have been in use for decades and are standard in the industry. The lawsuit also alleges that Blue Shield has promised its customers it would build up a network of prosthetists, and failed to do so, forcing members to go out-of-network for prosthetic limbs and resulting in large costs to them.
If you are suffering from limb loss and your insurance company has failed to properly cover your prosthetic limbs, call me, Conal Doyle, Amputation Attorney, at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation.