A review of data filed by insurers with the California Department of Managed Care showed more than one out of five requests for medical services—including those recommended by a patient’s physician—were rejected by the state’s largest private insurers, according to the California Nurses Association and National Nurses Organizing Committee (CNA/NNOC). From 2002 through June 30, 2009, insurers rejected 47.7 million claims for care, or 22% of all claims.

 

During the first six months of 2009, insurance companies in California rejected claims at the following rates: PacifiCare (39.6%); Cigna (32.7%); HealthNet (30%); Kaiser Permanente (28.3%); Blue Cross (27.9%); and Aetna (6.4%).

 

Deborah Burger, RN, CNA/NNOC’s co-president, said in a prepared statement: “With all the dishonest claims made by some politicians about alleged ‘death panels’ in proposed national legislation, the reality for patients today is a daily, cold-hearted rejection of desperately needed medical care by the nation's biggest and wealthiest insurance companies simply because they don’t want to pay for it.”

 

Case in point: Nataline Sarkisyan, a 17-year-old Northridge girl who died in December 2007 in a hospital after her insurance company, Cigna, waited until the last hours of her life to approve her for a liver transplant. Prior to the day Sarkisyan died, Cigna twice took her off the liver transplant list in order to avoid paying for her after-care, according to an attorney representing the family in a lawsuit filed against the insurance company.

-Noel Brinkerhoff

 

California's Real Death Panels: Insurers Deny 21% of Claims (California Nurses Association)

Cancer Girl's Lawyer Blames CIGNA For Her Death (KCBS/KCAL 9, Los Angeles)