It can be really difficult for an amputation victim to not only live with the trauma of losing a limb, but then to have to fight with insurance companies over payment of medical expenses.
Insurance companies generally are not legally required to pay every medical expense that gets submitted to them. Medical bills for procedures which are experimental or are not medically necessary generally do not have to be covered, although it depends on the policy.
This could include some artificial limbs which are considered luxury items, such as an artificial leg designed for running, or a new type of limb which has not been thoroughly tested.
However, in many cases insurance companies will deny claims for amputees that legally they do have to cover. Insurance companies generally are not thrilled to issue policies to amputees, because the medical expenses for most amputees are so high.
In most cases, they are legally prevented from refusing to issue the policy, so instead the company may simply refuse to pay claims.
So how do you know if your insurance company is acting in bad faith in refusing to pay charges?
If your insurer delays in sending payment, refuses to act promptly when it’s notified of a claim, fails to do a thorough investigation into the claim, attempts to settle the claim on the basis of a policy which was altered without notice or consent, fails to provide a reasonable explanation of why a claim was denied, uses harassment or intimidation towards the insured, or fails to conform to industry standards, those are some of the signs that you are dealing with an insurance company that is behaving illegally.
Fortunately, legal help is available. I have experience with suing insurance companies for bad faith over their refusal to pay amputation-related expenses.
Call me, Amputation Lawyer Conal Doyle at 310-385-0567. As an amputee, I enjoy forcing insurance companies to pay for what they are legally required to pay.