Los Angeles Aetna Health Insurance Denial Lawyer

Health insurance policies are contracts, and as such health insurance companies such as Aetna have a duty to engage in good faith and fair dealing. This mandates that neither Aetna nor any individual holding the policy would do anything to injure the other’s rights to receive the benefits of the agreement.

For the insurance company, this means they get paid. For the policyholder, it means they receive the care guaranteed under their insurance policy. However, all too often an insurance company denies a claim for a seemingly mundane reason, leaving policyholders with thousands of dollars of medical debt.

If Aetna denied your health insurance claim, you have the right to appeal their decision with a health insurance denial attorney’s help. A Los Angeles Aetna health insurance denial lawyer can help you navigate the complexities of insurance law and appeals and work to recover compensation for your losses or help secure coverage for a procedure.

The Costs of Aetna Health Insurance Denials

Health care costs have climbed dramatically over the last several decades. According to statistics released by the Henry J. Kaiser Family Foundation, the national average daily cost for an individual to stay in a hospital is slightly over $2,000.

The average cost for an individual to stay a single day in the hospital in California was closer to $3,000 in a state or local government hospital and $3,752 at a non-profit hospital. These statistics underline the importance of having an insurance policy.

Understanding Policyholder Rights

Having health insurance often gives people a sense of security, as it seemingly guarantees that they would be able to see a doctor and afford proper medical care if they ever needed it. However, if a health insurance claim is denied, it is important for individuals to understand their rights. Generally, insured individuals have the right to:

  • Information about why their claim or health care coverage was denied
  • A right to examine and respond to all information used in Aetna’s internal appeal decision
  • A right to engage in an independent review of the appeal

A Los Angeles Aetna health insurance denial lawyer could help protect an individual’s rights while advoating for them.

Investigations Against Aetna

The California Department of Managed Health Care and The California Department of Insurance recently announced that they would be investigating Aetna for engaging in unfair insurance practices and unfairly denying claims. Furthermore, policyholders accused Aetna of denying medical coverage without having a physician review a patient’s records.

Even if they accept a claim, health insurance companies like Aetna are notorious for underpaying on health insurance claims. Despite receiving regular payments from policyholders, insurance companies may refuse to pay for a course of treatment and instead suggest a lower cost procedure or treatment. In addition, health insurance companies often offer to cover only a partial reimbursement of a treatment or procedure.

Getting Help from a Los Angeles Aetna Health Insurance Denial Attorney

Aetna and other large health insurance companies are ultimately businesses that want to make money. However, this should not be at the expense of your health and wellbeing. A dedicated Los Angeles Aetna health insurance denial lawyer can help you manage the stress a health insurance denial can have on you and your family and stand up to large insurance companies to pursue the benefits you deserve.