CA Insurers Rejected 26% Of Healthcare Claims In 2010

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jun 19, 2018

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CA healthcare insurance claim denial rates for the first 3/4 of 2010 were a shocking 26% – many of which will result in bad faith insurance lawsuits. So, of the 13.1 million claims rejected, which insurance companies were the worst offenders? Unfortunately, the results won’t shock most Californians.

PacifiCare Rejected “Obscene” Number Of Healthcare Claims

Healthcare giant PacifiCare reportedly denied nearly 44% of all healthcare claims submitted. That percentage, which may seem shocking to most, is actually only a bit higher than other insurers like Cigna and Anthem Blue Cross according to data collected from California’s Department of Managed Care (CDMC). Here’s a breakdown of rejection rates by California’s largest insurance companies in the first three quarters of 2010:

  • PacifiCare: 44%
  • Cigna: 40%
  • Anthem Blue Cross: 27%
  • HealthNet: 24%
  • Blue Shield: 22%
  • Kaiser Permanente: 20%
  • Aetna: 6%

These percentages have been called obscene and may be adding to the financial woes of many Americans. In fact, according to DeAnn McEwen, Co-President of the California Nurses Association/National Nurses United (CNA/NNU) was quoted as saying, “These obscene rejection rates demonstrate one reason medical bills are a prime source of personal bankruptcies as doctors and hospitals will push patients and their families to make up what the insurer denies.”

What’s worse is that these high rejection rates aren’t new for 2010 and continue to provide insurers with huge profits by simply keeping your premiums. California insurers have reportedly rejected over 67 million healthcare claims since 2002. According to bad faith insurance lawyers, with the exception of Aetna, these rejection rates will likely result in an increase in bad faith insurance lawsuits.

Bad Faith Insurance Lawsuits: Evening The Odds

Policyholders whose claims have been delayed or denied, or whose policies have wrongfully been rescinded altogether, can fight back by filing a bad faith insurance lawsuit against their insurance company for not treating them fairly and in good faith – and can perhaps even the odds a bit.

If you’ve been treated unfairly by your insurance company, you owe it to yourself to find out more by contacting an experienced bad faith insurance attorney to discuss your situation, determine whether you might be entitled to compensation and see if filing a bad faith insurance lawsuit might be in your best interests.

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