Aetna Claim Denials Attorney

Experienced Aetna Claim Denial Lawyers Serving Clients Around the USA

Aetna Claim Denials lawyerAetna Life Insurance Company, founded in 1853 in Hartford, Connecticut, is a prominent provider of health, life, and disability insurance, serving approximately 22 million medical members. Named after Mt. Etna, Europe’s most active volcano, Aetna holds a significant place in insurance history as the first insurer to advertise on television. In November 2018, CVS Health acquired Aetna for $69 billion, marking the largest merger in U.S. healthcare history.

Aetna’s Disability Insurance and Claim Challenges

Aetna’s disability policies cover over 2 million Americans through 2,100 employers, processing around 2,000 new disability claims weekly. Offering both short-term and long-term disability plans, Aetna provides financial support by covering a portion of lost wages for approved claims. However, many policyholders face challenges with claim denials, often requiring the expertise of an attorney to navigate the complex appeals process. At Eric Buchanan & Associates, our experienced attorneys specialize in helping clients secure the benefits they deserve when Aetna wrongfully denies disability claims.

Legal Challenges and Investigations

Aetna has faced significant scrutiny over the past decade due to lawsuits and investigations related to rejected claims, discriminatory practices, and inadequate payouts. These cases highlight the importance of consulting an Aetna claim denials attorney to hold the insurer accountable.

Medicare Advantage Overpayments (2023)

A 2023 audit by the U.S. Department of Health and Human Services’ Office of the Inspector General revealed that Aetna received an estimated $25.5 million in Medicare Advantage overpayments for 2015 and 2016. Aetna was required to refund $632,070 to the Federal Government, underscoring issues in their claims processing systems.

Cunningham Case (2018)

In 2018, Orrana Cunningham, an Oklahoma cancer patient, sued Aetna after the company denied coverage for proton beam therapy in 2014. Following her death in 2015, her husband, Ron, pursued the case. A jury ruled that Aetna acted in bad faith, awarding $25.5 million—the largest verdict in an individual “bad faith” insurance case in Oklahoma history, as reported by CNN. Cases like this demonstrate why policyholders often need an attorney to challenge wrongful denials effectively. Contact us for expert legal support in similar situations.

California Investigation (2018)

Axios reported in 2018 that Aetna faced an investigation by the California Insurance Commissioner after a medical director admitted to never reviewing patient records before approving or denying coverage. Instead, the director relied on nurses’ recommendations without proper training. The case, settled in 2019, highlighted systemic flaws in Aetna’s claims process. If you’ve experienced a wrongful denial, an Aetna claim denials attorney from Eric Buchanan & Associates can help you appeal and fight for your benefits.

Breast Cancer Reconstruction Lawsuits (2023)

In October 2023, Law.com reported that Aetna faced 21 lawsuits in a single week from the Plastic Surgery Center in Shrewsbury, New Jersey. The lawsuits alleged that Aetna promised to cover bilateral breast reconstruction surgeries for breast cancer patients at in-network rates but paid only about 5% of the agreed cost post-procedure. These denials left patients and providers financially burdened. Our disability insurance law firm has extensive experience representing clients in such cases, ensuring Aetna honors its commitments. Reach out to our lawyers for a consultation.

LGBT Discrimination Class Action (2021)

A 2021 class action lawsuit, Goidel v. Aetna Life Ins. Co., claimed Aetna discriminated against LGBT members by requiring them to pay thousands for artificial insemination before covering fertility treatments—a requirement not imposed on heterosexual couples. Settled in 2024, Aetna established a $2 million reimbursement fund and revised its policies to ensure equal coverage nationwide. This case illustrates Aetna’s history of claim-related disputes, where legal intervention by an attorney can lead to justice and policy change.

Why Choose Eric Buchanan & Associates?

Navigating Aetna’s claim denials can be overwhelming, but you don’t have to face it alone. At Eric Buchanan & Associates, our Aetna claim denial attorneys bring decades of experience fighting for policyholders nationwide. We understand the tactics insurers use to deny valid claims and are committed to securing the benefits you’re entitled to. Our firm has a proven track record of success in disability insurance disputes, offering personalized, compassionate legal representation.

How We Can Help

  • Appealing Denied Claims: We meticulously review Aetna’s denial letters and gather evidence to build a strong appeal.
  • Litigation Support: If your appeal is unsuccessful, our attorneys are prepared to take Aetna to court, as demonstrated in cases like the Cunningham lawsuit.
  • Expertise in Disability Insurance: Our focus on disability law ensures deep knowledge of Aetna’s policies and processes.
  • Nationwide Representation: We serve clients across the U.S., providing accessible legal support wherever you are.

If Aetna has denied your disability claim, contact Eric Buchanan & Associates today for a free consultation. Our Aetna claim denial attorneys are here to fight for your rights and help you obtain the benefits you deserve.