The Washington Office of the Insurance Commissioner has fined Aetna Life Insurance Co. $65,000 or denying more than 200 claims related to acupuncture treatment.
According to Aetna’s consent order, the insurer unreasonably denied claims for acupuncture treatment and denied acupuncture claims for certain conditions without reliable supporting information or evidence demonstrating that such treatment was not cost-effective or clinically effective for such conditions.
The claims occurred between July 1, 2008 and June 30, 2010. During that period, the OIC said 1,761 acupuncture claims had been received, with 220, or 12,6 percent wrongfully denied. A total of $16,274 was repaid to insureds, plus 12 percent interest.
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