NEW ORLEANS – The parent of a child who suffers from Osteogenesis imperfecta claims that Blue Cross Blue Shield has failed to properly pay the transportation costs it allegedly was to cover.
Timothy Wilson, in his capacity as legal guardian for L.W., and Aviation West Charters LLC, doing business as Angel MedFlight, filed a lawsuit Feb. 11 in the U.S. District Court for the Eastern District of Louisiana against Louisiana Health Service and Indemnity Co., doing business as Blue Cross Blue Shield of Louisiana, over alleged violation of defendant’s obligation to the Employment Retirement Income Security Act.
The plaintiffs assert that L.W. suffers from a disease which makes her bones brittle and easily broken. She has allegedly endured multiple fractures and surgeries due to her condition. On November 2013, L.W. fell and fractured her upper leg, dislodging a nail that was previously been implanted in her leg, the complaint states. She allegedly required surgery at Children’s Hospital in Omaha, Nebraska. L.W. lives in Mississippi and she had to be flown and transported by Angel MedFlight to Omaha on Jan. 20, 2014, the suit states.
The plaintiffs allege that the defendants preauthorized the surgery and ambulance transportation. They attest that they submitted the claims in a timely manner, but the defendants allegedly paid less than 7 percent of the transportation charges, which is allegedly substantially less than the comparable and customary charges. The plaintiffs claim to have made several appeals but to no avail.
They are now seeking the court to award them reimbursement of the costs for ambulance transportation, prejudgment interest on the costs incurred, and any and all damages to which they believe they are entitled. They are represented by Reagan L. Toledano from Willeford & Toledano in New Orleans.
U.S. District Court for the Eastern District of Louisiana Case number 2:16-cv-01230