United Healthcare, a health insurance company, was sued late last year by two individuals suffering from limb loss. The lawsuit alleges that the company issues blanket denials for some types of prosthetic limbs without any type of investigation into whether the limb is needed for the situation. The plaintiffs are seeking to turn the lawsuit into a class action so that other amputees can join the lawsuit.
According to the lawsuit, United has guidelines that determine whether or not certain devices and services are covered under its insurance policies. The guidelines for prosthetic limbs state that “If more than one prosthetic device can meet the member’s functional needs, benefits are only available for the prosthetic device that meets the minimum specifications for the member’s needs.”
The lawsuit alleges that United uses this guideline to deny all requests for all computer-powered prosthetic arms and leg devices without any investigations. The lawsuit claims that United does not assess or determine the claimant’s needs, how the requested prosthetic device meets the minimum specifications of the claimant’s needs, or identify an alternative device that will meet the claimant’s needs. Instead, United simply issues blanket denials, according to the lawsuit.
The plaintiffs are seeking to turn the lawsuit into a class action and to force the company to change its policies. If you are an amputee and you have had your claims for a prosthetic device denied by your insurance company, call me, Conal Doyle, amputation attorney, at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation on your case.