Three major insurance companies, Anthem, United, and Blue Shield, have recently been sued for their failure to pay for prosthetic limbs for their customers. Each of the lawsuits was filed late last year, and all three lawsuits are seeking to be certified as a class action lawsuit.
The lawsuits, while all slightly different, all claim that the insurance company wrongfully refused to pay for a microprocessor-controlled prosthetic limb. Microprocessor-controlled prostheses use computers and sensors and can react in real-time to help the user with stability, dexterity, and many other benefits. The other alternative is body-powered limbs, which are normally more uncomfortable, less safe, and less functional.
Generally, insurance companies have been reluctant to pay for microprocessor-controlled limbs because of the high expense. They often claim that other limbs are all that are needed and are all that the policies cover. They may label microprocessor-controlled limbs as “investigational” or “not medically necessary” in order to avoid paying for the devices.
If you have had a claim for a prosthetic limb denied by your insurance company, and you believe that denial was in violation of the law, you should speak with an attorney. Call me, Conal Doyle, Amputation Attorney, at 310-385-0567. I can help. Call me today to learn more or to schedule a free consultation on your case.