United Healthcare, a large insurance company, was sued in court in California late last year for its failure to provide coverage for some types of prosthetic limbs. The company was sued by two people who are suffering from limb loss whose claims for limbs were denied.
The company issued denials for the plaintiffs’ limbs that were requested. The plaintiffs sought coverage for microprocessor-controlled limbs, which are artificial limbs that are controlled by computer chips. The limbs have been standard for decades. The company issued the denials on the basis that the limbs exceed the minimum standards for the plaintiffs’ needs. The insurance company’s policy is that it will only cover prosthetic devices that meet the minimum specifications for the customer’s needs.
The lawsuit claims that United Healthcare simply issued a blanket denial for the limbs without examining the plaintiffs’ situations in any detail. According to the lawsuit, United Healthcare simply saw that a more complex limb was being requested and issued a denial without examining the facts of the situation.
The plaintiffs are seeking to force the company to change its policies, as well as to force the company to pay for their limbs and to compensate them for other expenses. The lawsuit may be a class action lawsuit, which could help other amputees whose claims have been denied by United Healthcare. If you have had a claim for a prosthesis denied by United Healthcare, call me, Conal Doyle, personal injury attorney, at 310-385-0567. I currently have several lawsuits underway against insurance companies, and I am happy to speak with you about your situation. Call to learn more or to schedule a free consultation.