Blue Cross Insurance Denials for Plastic Surgery Lead to Class Action Lawsuits

California insurance giant Blue Cross is being sued for wrongfully denying insurance claims for various plastic surgery procedures including body lifts, tummy tucks, and other procedures. Class action lawsuits have been filed by plaintiffs who allege Blue Cross regularly denies coverage for these procedures in bad faith.

Blue Cross, or Anthem Blue Cross, is a major U.S. health insurance provider, and is a subsidiary for the insurance giant Wellpoint. Anthem has about 800,000 customers, and more individual policyholders in California than any other insurer. The insurer had a net income of $2.49 billion in 2008, and $4.7 billion in 2009.

Despite the popularity of Blue Cross, the company has been recently hit with class action lawsuits over wrongful claim denials. When the recession first hit in 2007, the California Department of Managed Health Care (DMHC), a state regulatory agency, investigated the company’s policies for revoking active health care insurance policies without telling their customers.

The DMHC randomly selected 90 cases for which Blue Cross unexpectedly canceled the insurance policies after policyholders suffered costly or life-threatening illnesses, and investigated to see if the company had legal reason to deny them. The DMHC concluded that Blue Cross lacked legal grounds for cancelling all of the policies, and the insurance agency had done that to retain their profit margins.

Blue Cross had another mishap in 2010 when the rates for their insurance plans increased exponentially, causing them to lose customers as well as employees. Blue Cross explained that due to unemployment and declining wages, many customers dropped their insurance policies, while the remaining customers became sicker and more expensive to insure. In response to this move, California legislators have proposed giving the government the authority to block insurance premium raises when they are unjustified.

Recently, Blue Cross has come under fire regarding its allegedly bad faith insurance practices in turning down plastic surgery claims. While plastic surgeries are typically considered for cosmetic in nature, patients will sometimes need them for reconstructive or health purposes. The reasons can be to remove excess skin from a bypass surgery, to covering a scar left from an accident.

Overview of Plastic Surgery Insurance Denials

It has been reported that patients who are denied medically need plastic surgery procedures face a variety of physical and emotional challenges, including stress, depression, anxiety and severe mood swings. Like any insurance company, Blue Cross has the obligation to follow regulations in reviewing each insurance claim for full consideration.

Bad faith insurance practices take place when an insurer wrongfully withholds or denies a claim without legitimate reason or review. Plastic surgeries are among the most common insurance denial situations, because insurance companies often assume the surgeries are needed for cosmetic reasons. As mentioned before, these procedures are sometimes medically needed to allow the patient to resume a normal life.

Join a Free Blue Cross Insurance Denial Class Action Lawsuit Investigation

If Blue Cross denied your tummy tuck cost reimbursement, or refused to cover other types of plastic surgery such as body contouring, body lift, breast lift, breast reconstructive surgery, eye lift, eyelid lift, abdominoplasty and panniculectomy, you may qualify to join an Insurance Denial Class Action Lawsuit Investigation and pursue compensation for your denied claim.

Claims are being accepted now for the following types of Blue Cross bad faith denials:

• Tummy Tuck
• Body Lift
• Breast Lift
• Boob Job – Reconstructive Breast Surgery
• Eyelid Lift
• Circumferential Body Lift
• Arm Lift
• Leg Lift
• Buttock Lift
• Complete Lower Body Lift
• Mini Tummy Tuck
• Abdominoplasty
• Panniculectomy
• Other medically necessary plastic surgery