Aetna Cancels Coverage – Patient Never Received Notice of Increase Until 2 Months After It Took Effect

This is a good story here when you read the entire saga. It first of all goes to show how powerful the software screens are that present information to employees and what to base their decisions on. The woman was not notified until the increase was already 2 months in effect and had no idea she had been cancelled until a claim for a visit made within that 2 month time frame had been denied. The patient is a cancer survivor and went to a journalist at the Los Angeles Times to help her out. The paper trails were exactly as she said they were, but all her efforts to get re-instated with Aetna were futile. If this were me I would begin to wonder if I was in the group of 600,000 unprofitable insured they have publicized about cutting from the ranks.

Finally when an appropriate level of supervision was reached the company did admit to the fact that they could have done a better job. This is just one of many tales where people have the same problem, human intervention and varying from the algorithmic formulas presented on the screen to see if there are some human factors to look at here. It is amazing how powerful the screens are and the fact that nobody will question the decision making processes put in front of them, even if issues look like they need a human to intervene. She was finally reinstated after one huge effort here and then it gets better, she found another alternative insurance plan through an association that was cheaper at half the amount, only problem, it is offered by Aetna. BD

Los Angeles resident Stacey Owens found out after a recent doctor's visit that her health insurer, Aetna, had canceled her coverage, ostensibly because she'd missed a monthly payment.
Never mind the heartlessness of leaving people uninsured because of something as potentially trivial as a misplaced bill.
No, the problem in this case is that Owens, 25, never missed a payment -- and she has the bank records to prove it.
Yet when she confronted Aetna with what clearly appeared to be a clerical error on the company's part, Owens said, the insurer dug in its heels and refused to reinstate her coverage.

Aetna reinstates customer who made $64 error - latimes.com