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Health Insurance Companies Fined $767 Million for Recissions (Denials)

June 26, 2012 Leave a comment
Health insurance companies have a “fetish” for denying people access to health care. The only reason they do this is to gain/ save company profits for their shareholders and to pay high compensation packages to executives. This evidence is clear in the raw data posted below. According to the data, insurers have specifically denied 25,871,003 (publicly reported) and have been fined $768,755,406  over the past decade. Unfortunately, the denial by the health insurance companies have caused “murder” 4 times (publicly reported) and had judgments due to the “murders” totaling $131,900,000.  In several instances, health insurance companies denied 21,600 claims just to gain $335,500,000 in profit. As a result, an executive was paid a $20,000 bonus for each person denied. In addition, the overall average denial rate by health insurance companies is 30.2%. For-profit Aetna fined the most for denials by a whopping $325,500,000. Nonprofit Blue Cross Blue Shield fined a whopping $205,957,000.
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Deaths caused by Insurer Denials
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Aetna (publicly traded)
# of deaths:  1   (Source 39)
judgments:   $124,500,000  (Source 39, 40)
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Cigna (publicly traded)
# of deaths:   1   (Source 36)
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Humana (publicly traded)
# of deaths:   1   (Source 37)
judgement:   $7,400,000    (Source 37)
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Magellan (publicly traded)
# of deaths:  1    (Source 38)
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Denied in order to save Profit (Evidence!)
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Health Net
Saved  $35,500,000 by denying 1,600 claims. Senior analyst got $20,000 bonus as a result.  (Source 21)
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United Healthcare, Blue Cross, Assurant
 Saved  $300,000,000  by denying 20,000 claims  (Source 34)
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Claims Denied by Insurer
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Assurant
# of claims:  20,500                      (Source 4)
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Blue Cross Blue Shield
# of claims:  10,263,365   (Source 2, 3, 9, 10, 18, 22, 27, 28, 29, 30, 33)
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Health Net
# of claims: 7,619,266        (Source 1, 23, 33)
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United Healthcare
# of claims: 7,967,872     (Source 6,7, 12, 17, 33)
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Insurer Denial Rates
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Aetna
denial rate:  13% (Source 33, 35)
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Blue Cross Blue Shield
denial rate:  28%   (Source 33, 35)
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Cigna
denial rate:  33%  (Source 33, 35)
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Health Net:  30% (Source 33, 35)
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Humana:  40%   (Source 35)
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Kaiser
denial rate:  28% (Source 33, 35)
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United Healthcare
denial rate:  39.6%  (Source 33, 35)
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Reasons for Denial by Insurer
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Aetna
denied qualified applicants coverage ( Source 1)
denied stomach cancer treatment (Source 32)
denied mental health, pap smears, mammograms, pediatric care (Source 41)
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Amerigroup
denied pregnant women on Medicaid access to care (Source 20)
failed to allow pregnant women to enroll in Medicaid (Source 20)
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Blue Cross Blue Shield
denied coverage to newborns (Source 1)
denied access to emergency care (Source 2, 3)
denied prosthetic legs (Source 8)
denied seniors access to drugs (Source 9)
denied anorexia treatment (Source 10)
denied routine colonoscopy (Source 11)
denied treatment for glutaric academia (Source 12)
denied mental health coverage (Source 18)
denied chemotherapy, physical therapy (Source 19)
denied people when they got sick (Source 22)
denied people when they got sick (Source 24)
denied sick children coverage     (Source 26)
denied women access to contraceptives (Source 27)
denied women coverage due to breast cancer diagnosis (Source 28)
denied women access to contraceptives (Source 29)
denied emergency room claims (Source 30)
denied pediatric cardiac lead tests (Source 31)
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Cigna
inappropriate denials  (Source 1)
denied liver transplant, patient died (Source 14)
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Conseco
improper denials (Source 1)
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Coventry
denied Medicaid patients drug needed by pregnant women (Source 1)
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Health Net
denied qualified claims  (Source 1)
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Kaiser
denied patients access to emergency care, resulted in 3 deaths (Source 2)
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Qualmed
denied patients access to emergency care (Source 2)
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United Healthcare
denied patient claims for emergency care (Source 2)
denied surgeons from scheduling legitimate surgeries (Source 6)
denied children access to pediatric care (Source 6)
denied patients with pre-existing conditions (Source 7)
improperly denied qualified claims  (Source 13)
denied anesthesiology claims  (Source 16)
denied qualified physician claims (Source 17)
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Fines for Denial by Insurer
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Aetna
Fined $327,055,000 (Source 1, 32, 39, 40, 41)
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Amerigroup
Fined $162,000,000  (Source 20)
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Blue Cross Blue Shield
Fined $205,957,000 million   (Source 1,2,3,10,15,19,22,24,26,27,28,29,30)
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Cigna
Fined $400,000    (Source 1)
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Conseco
Fined $500,000  August 2009 (Source 1)
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Fortis
Fined $15,000,000   (Source 5)
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Health Net
Fined $25,000,000  (Source 23)
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HMO Colorado
Fined $252,500     (Source1)
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Humana
Fined $7,400,000  (Source 37)
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Kaiser
Fined $1.1 million    June 2002 (Source 2)
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QualMed
Fined $25,000  (Source 2)
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United Healthcare
Fined $24,065,906   May 2009  (Source 1,6,7,12,17)
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Sources:
24. http://articles.latimes.com/2006/sep/22/business/fi-revoke22

41. http://www.mass.gov/ago/news-and-updates/press-releases/2012/2012-06-27-aetna-life-insurance.html
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