Late last year, two amputees sued United Healthcare on behalf of themselves and others. United Healthcare, a health insurance company, has refused to pay for myoelectric artificial arms for its customers. The customers claim that the company has acted in bad faith in its refusal to provide coverage.
According to the lawsuit, by the 1980s myoelectric arms were in use in rehabilitation centers around the world. They are commonplace today. Myoelectric arms have much better comfort, functionality, and appearance when compared with arms that are powered by the body. In addition, myoelectric arms are essential for the various activities of daily living, such as grasping objects and moving the hands with dexterity.
United has a guideline that it has used to deny claims for myoelectric arms. That guideline provides that benefits will only be provided for the prosthetic device that meets the minimum specifications for a customer’s needs. The lawsuit alleges that the company uses that guideline to systematically deny prosthesis devices without assessing or determining the individual’s functional needs.
The lawsuit against United is still ongoing, and several other lawsuits are also underway relating to insurance companies and their refusal to pay for prostheses. If you have had your claim for a prosthesis denied, you should speak with an attorney. Call me, Conal Doyle, Amputation Attorney, at 310-385-0567 to schedule a free consultation.