Aetna
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Aetna Inc., (NYSE: AET) founded in 1850, is based in Hartford, Connecticut. Aetna is the direct descendant of Aetna Insurance Company, which issued its first life insurance policy in 1850. Aetna offers traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, long-term care, short term and long term disability plans and medical management capabilities.
In 1960, the company expanded outside the U.S., buying a Canadian company, Excelsior Life Insurance Company. In 1968, it bought a majority interest in Producer’s and Citizen’s Cooperative Assurance Company, of Sydney, Australia. In 1981, it bought a 40 percent interest in two Chilean companies. In 1998, Aetna bought NYL Care Health Plans for $1.05 billion, adding 2.2 million members. The next year, it bought Prudential HealthCare for $1 billion, making it the largest provider of health benefits in the U.S., with more than 21 million members. In 2000, Aetna sold its financial services and international businesses to ING for $7.7 billion, and focused its business as an independent health and group benefits company, which includes short and long-term disability plans.
In 2002, Aetna agreed to streamline communications, reduce administrative complexity, and improve the quality of the health care system, ending litigation between Aetna and 700,000 physicians and medical societies. The agreement also resulted in establishment of an independent foundation (Physicians’ Foundation for Health Systems Excellence) to focus on critical health care issues and a physicians’ advisory board. Around this time, Aetna also became a founding member of CAQH an alliance of health plans and trade associations that work to simplify healthcare administration. Aetna subsidiaries include Aetna Life, Aetna Health of California Inc., Aetna Life Insurance Company, and Aetna Dental of California Inc. Aetna is a member of the Fortune 100. Aetna’s 2008 revenue was $31 billion.
As disability insurance attorneys, Dell & Schaefer have represented numerous clients with their long-term disability claims against Aetna and its affiliated companies. Disability Attorneys Dell & Schaefer have provided and offer the following legal services for disability claimants that have a long-term disability insurance policy or disability income policy purchased from Aetna:
- Application for long-term disability benefits with Aetna
- Application for short-term disability benefits with Aetna
- Monthly claim handling of Aetna long-term disability insurance claims
- Appeal of a Aetna denial of long-term disability benefits
- ERISA appeal of an Aetna denial of long-term disability benefits
- Lawsuit against Aetna for denial of long-term disability benefits
- Lump-sum buyout of an Aetna long-term disability insurance policy
- Department of Insurance complaints against Aetna for wrongful delay and denial of long-term disability benefits
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- Aetna’s denial of disability benefits to an OBGYN physician is reversed following an appeal submitted by attorneys Dell & Schaefer
- Broadspire and Aetna deny long-term disability benefits to manager suffering from fibromyalgia, arthritis and cervical disc disease
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Sir, I had insurance with BlueCross Blue Sheild for fifteen years, no problems. I was laid off April of ’09 with continued coverage through Cobra. I was told by an agent that Aetna offered similar coverage to what I had. Three months into the policy my wife, a personal trainer, had a heart attack. I drove her to the hospital, the doctor called for a helicopter and she was medivaced to another hospital and, thank god, she is ok. Since then Aetna has refused to pay for almost everything, giving every excuse in the book. She also has prescriptions they won’t copay, plasic two hundred dollars a month, they say they will only pay for generic. You get the picture. I would like to find another insurance company and sue Aetna for false advertising.
I have or should i say had, Aetna short and long term disability insurance. This company is a total ripoff. They are really good at collecting premiums, but God help you if you need them to pay off. Good luck getting them to return calls, you my as well call the moon, you would have better luck hearing from one of the rocks up there, than from this company.
I was placed on short term disability last year for about 3 months after a car accident and my STD insurance company Aetna paid me for the 3 months I was on leave. I returned back to work and began having issues again and changed doctors as my prior doctors did not know how to treat me. I was sent to a chiropracter who was treating me. He placed me on STD leave in Feb, 2011 for 2 weeks and 2 days thinking this would help my condition. Upon his evaluation after the leave, I was only allowed to return to work on a part time basis. He also sent me to a Neurologist who ended up diagnosing me with Fibromyalgia. The chiropracter advised that he believed that I had other issues with my back. Aetna paid me part-time until April 1, when I was placed on full-time disability leave. They denied my claim and upon appeal, sent my case to a Rheumatologist to evaulate. Please note Aetna is also my medical insurance company. These doctors did not make my primary care doctor aware of all of this as they told me they were. Upon advise of a friend, I spoke with both doctors about seeing a rheumatologist and they said it wouldn’t hurt. While waiting for appointment to see rheumatologist, Aetna denied my appeal. I have since seen my primary care doctor who advised that both doctors should have sent me to a rheumatologist once the Fibromyalgia was diagnosed. I have since seen the rheumatologist who confirmed that I do indeed have Fibromyalgia. He has ordered further testing and suspects that I might possibly have Spondloaropathy. I only have the MRI left to do. He has also diagnosed me with restless leg syndrome and per a sleep study results, I have sleep apnea. I have applied for Social Security Disability and am waiting for an answer. However in the meantime, I have no income coming in. How do I proceed about Aetna STD and their denial of my claim considering my current diagnosis?
Marlene,
If you have exhausted all of your ERISA appeals, then you have the option to file a lawsuit against Aetna at this time. In order to determine if we could assist you we would need to review your denial letter and a copy of your Aetna Disability Policy.
Resubmit, resubmit over and over again. Ask for further review, preferably with a bit of new medical info. It should be in your policy book. Appeal over and over again. Each time it is supposed to go to someone above who originally denied the claim. You can write to the insurance commissioner in your state and complain, and you can write to your state legislators and federal ones too. They are usually pretty fast at answering these letters.