InsuranceComplaintCheck

AETNA HEALTH AND LIFE INSURANCE COMPANY — health Insurance Complaints

Analysis of 153 health insurance complaints filed against AETNA HEALTH AND LIFE INSURANCE COMPANY, based on public NAIC and state DOI data.

Key Statistics

  • health Complaints: 153
  • Total Complaints (All Types): 188
  • health Share: 81.4%
  • NAIC Complaint Ratio: 1.01
  • AI Risk Score: 46/100

health Complaint Issues

Issue TypeComplaints% of Total
Claim denial4026.1%
Provider or network dispute3220.9%
Delayed payment2214.4%
Unfair settlement159.8%
Coverage dispute85.2%
CPT Code Issue | Claim Handling63.9%
Other42.6%
Premium or billing dispute32.0%
Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Company Position Substantiated21.3%
Claim Handling Other | Claim Handling21.3%
Claim Procedure | Claim Handling | Claim Settled21.3%
Claim Procedure | Claim Handling10.7%
Misleading sales10.7%
Policy Service | PolicyHolder Service | No Action Requested/Required10.7%
Authorization Dispute | Claim Handling | Question of Fact/Contract/Provision/Legal Issue10.7%
Co-pay, Deductible, and Co-Insurance Issues | Claim Handling10.7%
UR INTERNAL/EXTERNAL APPEAL PROCEDURE | Claim Handling | Company Position Substantiated10.7%
Recoupment | Claim Handling | Company Position Substantiated10.7%
Inadequate Reimbursement/Rates | PolicyHolder Service10.7%
Prompt Pay | Claim Handling | Company Position Overturned10.7%
Policy Service | PolicyHolder Service | Company Position Overturned10.7%
Prompt Pay | Claim Handling | Insufficient Information10.7%
CPT Code Issue | Claim Handling | Question of Fact/Contract/Provision/Legal Issue10.7%
Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Company Position Overturned10.7%
CPT Code Issue | Claim Handling | Company Position Substantiated10.7%
Claim Recoding/Bundling | Claim Handling10.7%
Policy cancellation10.7%
Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished10.7%

health Complaints by State

StateComplaints
Connecticut131
Texas22

Recent health Complaints Against AETNA HEALTH AND LIFE INSURANCE COMPANY

Frequently Asked Questions

How many health complaints does AETNA HEALTH AND LIFE INSURANCE COMPANY have?

AETNA HEALTH AND LIFE INSURANCE COMPANY has 153 health insurance complaints on file, according to NAIC and state DOI data.

What are the most common health complaint issues with AETNA HEALTH AND LIFE INSURANCE COMPANY?

The most common health complaint issues for AETNA HEALTH AND LIFE INSURANCE COMPANY are: Claim denial (40), Provider or network dispute (32), Delayed payment (22), Unfair settlement (15), Coverage dispute (8).

Which states have the most health complaints against AETNA HEALTH AND LIFE INSURANCE COMPANY?

The states with the most health complaints against AETNA HEALTH AND LIFE INSURANCE COMPANY are: Connecticut (131), Texas (22).

health Complaints by State

AETNA HEALTH AND LIFE INSURANCE COMPANY Complaints by State

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