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Home > Practice Areas > Prosthetic Limb Denials

Prosthetic Limb Insurance Denials

After the loss of an arm or leg, amputees must relearn how to interact with the world around them. An amputation once meant that the amputee would never again be able to resume their normal life activities. However, the advances that have occurred in artificial limb technology in recent years offer prosthetic users far greater opportunities to live as they once did by playing their favorite sports, going on walks, or cooking for themselves. Tragically, despite the widespread availability of prosthetic devices that would significantly improve a patient’s quality and enjoyment of life, many health insurers deny patients’ requests for advanced prosthetics.

Denials of prosthetic limb claims may qualify as bad faith practices by insurers

These denials of tools that could improve patients’ lives aren’t just mean-spirited or greedy; they may also be violations of California laws on good faith and fair dealing in insurance contracts. California health insurance policyholders may have a right to compensation if they’ve been the victim of a wrongful claim denial or insurer bad faith. If you believe you’ve been the victim of insurance bad faith in Southern California, contact the Los Angeles insurance bad faith lawyers at Gianelli & Morris for an evaluation of your claim.

Insurers targeted for denying claims for microprocessor-powered prosthetics

Prosthetic limbs containing microprocessors offer a new level of control and safety for those needing prosthetics. The microprocessors installed in prosthetics provide better feedback on the wearer’s movements and gait, allowing the prosthetic to move in a more lifelike manner. This improved function can help the wearer, especially the elderly and athletic, avoid injuries caused by tripping or stumbling, providing greater stability.

Despite the ways that these devices can prevent future injury and promote greater comfort and quality of life for any wearer, insurers often immediately deny claims for advanced prosthetics. Insurers have also faced legal action for these denials. Recently, Anthem was targeted in a lawsuit filed by two customers who lost limbs and sought the stability and safety afforded by more advanced prosthetics. Despite research showing that microprocessor-powered prostheses are considered the industry standard and necessary for safe participation in the activities of daily life, Anthem had wrongly denied the claims on the basis that the prosthetics were still considered investigational and not medically necessary.

If you have been the victim of a wrongful claim denial after having a request for a prosthetic limb denied, find out if you’re entitled to seek money damages for a bad faith insurance claim denial by contacting the effective and dedicated Los Angeles insurance bad faith lawyers at Gianelli & Morris for a free consultation at 213-489-1600.

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