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California Nurses Association: Insurers like Cigna Are "the Real Death Panels"
| December 1, 2009. By Heidi Turner |
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Oakland, CA: Californians who have LINA insurance recently received the good news that the insurance giant would be reevaluating their denied LINA disability claims. However, a recent study has found that the Life Insurance Company of North America (LINA) and other insurers in California are continuing to reject claims at a high rate, putting people's health at risk.
 The study, released on September 5, 2009, found that California private insurers reject more than one in five requests for medical claims by insured patients, including those that come with a physician's recommendation. The study, conducted by the California Nurses Association (CNA) and the National Nurses Organizing Committee (NNOC), analyzed data provided by the insurers to the California Department of Managed Care.
According to the study, six of the largest private insurers in California rejected 47.7 million claims between 2002 and June 30, 2009—approximately 22 percent of all claims. Some insurers rejected more than 30 percent of the claims they received during the first six months of 2009.
The three highest rejection rates are boasted by PacifiCare (39.6 percent), Cigna (32.7 percent) and HealthNet (30 percent).
"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," said Deborah Burger, RN, CNA/NNOC co-president, in a news release.
"Every claim that is denied represents a real patient enduring pain and suffering. Every denial has real, sometimes fatal consequences."
The CNA/NNOC news release cites the example of Nataline Sarkisyan, who was denied a liver transplant by CIGNA. CIGNA reversed its decision too late, and the 17-year-old died awaiting her transplant. The organizations also cite Nick Colombo, a 17-year-old with bone cancer whose claim for a treatment was denied by PacifiCare. The company later reversed its decision, but Colombo died in the hospital.
"Rejection of care is a very lucrative business for the insurance giants," the CNA/NNOC news release states. "The top 18 insurance giants racked up $15.9 billion in profits last year." The release equated the insurance companies' rejections to those of a death panel.
Some of these rejections are legitimate claims that come with the recommendation of a doctor. Cigna-owned insurance company LINA has been ordered to review all claims denied between January 2005 and December 2007. Although that may help some policyholders whose claims could be overturned, it does not help those who have insurance policies with other companies. It also might not help those who have incurred massive medical expenses in the expectation that their insurance company would agree to pay their medical bills.
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