;
  • Report:  #191421

Complaint Review: Aetna Life Insurance Company - Lexington Kentucky

Reported By:
- Bakersfield, California,
Submitted:
Updated:

Aetna Life Insurance Company
P.O.Box 14548 Lexington, 40512-4548 Kentucky, U.S.A.
Phone:
800-523-5065
Web:
N/A
Categories:
Tell us has your experience with this business or person been good? What's this?
After 10 years I came to terms with a condition known as degenerative joint disease, I had to resign from a 20+year Radar career with Computer Sciences Raytheon.

I was certified as Totally Disable by two private physicians, and one from the SSA.

After I exhausted my medical leave (1 year) with the Corp. Aug.05 I received a letter from Aetna basically stating I do not qualify to retain my life insurance, as I had been classified as capable of sedentary activity after one of my numerous surgeries, L. hip(revision), spine (double laminectomy), and umbilical hernia, and still require the R. hip(revision), more spinal corrective procedures, arthoscopic surgery for both knees, and a mastoid abscess.

Since the time of Aug.05 I have exchanged numerous letters of correspondence with Aetna and the CA Department of Insurance, in an attempt to re-establish what should never have ceased.

I received a response from Aetna dated April 3/2006 which maintains Aetna's' opinion that I am something other than Totally Disable.

According to the SSA, The Hartford, and my primary care physician, Dr. Bradley Davis, I am classified as Totally Disable.

My appointment on the 11th April 2006 with Dr. Davis has reconfirmed my condition as Totally Disable, and by no means has ever reported any other condition than such.

I have given him copies of the letters I received from Aetna, I must say Dr.Davis did not appreciate Aetna's twisted methods of handling what should have been an act of standard operating procedure, when the proper forms are utilized.

The dates indicated in the letter from Aetna correspond with Dr. Davis's office notes regarding treatment, Dr. Davis has assured me that the office notes do not, and should not have been utilized to justify or constitute my Total Disability.

Dr. Davis has informed me that a letter will be generated and sent to Aetna indicating my limitations and physical conditions, which will justify my Total Disability.

In former correspondence, Aetna requested that I personally retrieve and send the office notes of Dr. Davis as justification for the appeal process, this requested action from Aetna raised the question of why didn't Aetna send the appropriate disability forms to Dr. Davis directly for SOP justification of my disability. Is it possible Aetna unlike all other insurance companies does not have any such Disability Claim Forms???

I am seeking any and all assistance in the recovery of my insurance benefits as expressed in Aetna's policy of Total Disability.

Please advise me as to my options, I do not intend to let this matter go unresolved.

In my physical condition I cannot acquire insurance, other than insurance that is beyond my financial reach.

Sincerely

Robert

Bakersfield, California
U.S.A.


6 Updates & Rebuttals

Robert

Bakersfield,
California,
U.S.A.
Justice Is Too Exspensive to Fight Aetna LTD.

#2Author of original report

Sat, December 22, 2007

Aetna LTD has Ripped Off my Life Insurance Policy. This matter has been addressed repeatedly with Aetna, the CA. Dept of Insurance, and a couple handfuls of Legal council reps., only to be told that in order to re-stablish a policy that should never had ceased, would require $3k to $33k in order to litigate it back into effect... Being one of the many SSDI monthly budget pinchers,, The Price of Justice, is far beyond my finacial reach. After a 20+ year carreer with the D.o.D. in paying into this policy has resulted in Wasted Time, Money, and only Provided a Totally False Sense of Security.. Beware of Your Life Insurance Provider,,, It Might Be A Big Ripp-Off!!! Especially Aetna LTD,, An Old Mattress would Have Worked Better!!! With No Help,, Robert V... P.S.What Part of Totally Disable Disable Didn't they Understand????


Robert

Bakersfield,
California,
U.S.A.
Justice Is Too Exspensive to Fight Aetna LTD.

#3Author of original report

Sat, December 22, 2007

Aetna LTD has Ripped Off my Life Insurance Policy. This matter has been addressed repeatedly with Aetna, the CA. Dept of Insurance, and a couple handfuls of Legal council reps., only to be told that in order to re-stablish a policy that should never had ceased, would require $3k to $33k in order to litigate it back into effect... Being one of the many SSDI monthly budget pinchers,, The Price of Justice, is far beyond my finacial reach. After a 20+ year carreer with the D.o.D. in paying into this policy has resulted in Wasted Time, Money, and only Provided a Totally False Sense of Security.. Beware of Your Life Insurance Provider,,, It Might Be A Big Ripp-Off!!! Especially Aetna LTD,, An Old Mattress would Have Worked Better!!! With No Help,, Robert V... P.S.What Part of Totally Disable Disable Didn't they Understand????


Lana

Sacramento,
California,
U.S.A.
What you may not know and should know about disability

#4Consumer Suggestion

Thu, September 07, 2006

Robert, I too have been fighting Aetna for disability benefits since 2003 and finally won partial benefits in 2005. I remain the victim of fraud and believe I can proove it: two versions of one policy sent with same issue and effective date with policy language altered to deny full benefits. If you purchased your disability policy through an employer, you are subject to federal law. It is called the Employee Retirement Income Securities Act of 1974 (ERISA). You will be required to file suit in federal court as this is federal law and cannot be tried under state law. I too dealt with C. Witt at the CA. Dept. of Insurance: He also did nothing or even tell me why. I have since contacted Senior Staff Council at the Department of Insurance. They will do nothing for an individual but, if we can collect more complaints, they might. Who are your Senators, congressman and State Assemblyman? (Election year). If you are lucky enough to have a private disability policy (not through an employer) sounds like a very good lawsuit. If you fall under ERISA law, the news is not good but, you should contact an ERISA attorney ASAP! To get an idea of what the process is check out www.theerisalawgroup.com. They explain the procedure. Be prepared to submit well organized binders and to several attorneys. You must use the insurance appeal process before filing suit and, the evidence you submit in that appeal process is the only evidence the court will consider; it isn't pretty! Try also the website for attorney Mike Mckuin, he provides a good overview; also www.sbd-law.com this one looks like a reputatable firm; phone is 800-458-3386), another is DeVries Law Firm, Sacramento, 916-473-4343. Do this quickly as there are statutes of limitations and Aetna will lead you on causing you to miss them. You do not need a local attorney for federal court. We should stick together as a concerted effort is more effective: publicity, help from elected officials, DOI (perhaps even class action). Contact me at [email protected]. Thanks also to Sue in PA. I don't know if the ADA special council can help but, it's worth a try.


Robert

Bakersfield,
California,
U.S.A.
Aetna Life Rip-Off, No-Help From Ca.Dept.Ins. & Dept.ofJustice,

#5Consumer Comment

Mon, August 21, 2006

Since August 2005, I have attempted to re-establish my Life Insurance through the Aetna appeal process, with The Assistance of The California Dept. of Insurance (CDOI). I have met and or exceeded all the qualifications as being Totally Disable, well within the time limitations Aetna has stipulated in past correspondence to maintain my life insurance. From the time I retained the services of the CDOI, I have not received any information in regards to, updates, acknowledgements, or any activities regarding the appeal process. After Aetna sent the Final Denial 4/06 with Cc: To: Senior Claims Compliance Officer: C.Witt, I expected something of a response from Mr. Witt or, any Rep. from the CDOI there was none... I am at a loss as to what assistance the CDOI actually provided in regards to this case, and furthermore I cannot believe the CDOI has let Aetna Life basically rob me of my policy. The 3rd of June 2006 I sent all medical and case history documentation to the Dept. of Justice (American Disability Act.). The response I received dated 28th June 2006 from Jeanine Worden Deputy Chief of the Disability Rights Section, had evident indications my complaint was not read in any form of detail. The response I received from Jeanine Worden basically stated they did have time to consider my case, nor did they have any intentions to, I was in fact sent a list of Independent Living Centers..Which Is A Clear indication my complaint was never read. I am requesting any and all assistance to help re-establish my life insurance. I do not believe my case has been given the attention and consideration it was due. Sincerely Robert


Robert

Bakersfield,
California,
U.S.A.
I appreciate It

#6Consumer Comment

Wed, May 17, 2006

Sue, I will definitely let you know and everyone that is watching this communique, what the results of the information you have provided me with turn out.. Thanks


Sue

USA,
Pennsylvania,
U.S.A.
Disability information

#7Consumer Suggestion

Mon, May 15, 2006

I am a licensed health and life agent in Pa. I am not connected with Aetna but I did some research and I believe you can find the help you need from one of the following agencies in regards to your problem with Aetna and your life insurance policy. Start with the American Disabilities Act service number and explain your situation at 800-514-0301. You may also try contacting the ADA special legal council at 202-616-7526. Also try the Ca. Dept. of rehabilitation at their client assistant number 800-952-5544. The Ca. consumer hotline for life insurance problems is 800-927-4357. If you suspect the company is engaged in fraud in regards to your policy you can also contact your regional office in Fresno that does serve Kern County at 559-253-7300. If your policy has a rider regarding total disability payments and the company refuses to pay, I would contact everyone of these offices and one of them should get Aetna to pay you. Best of luck

Reports & Rebuttal
Respond to this report!
Also a victim?
Repair Your Reputation!
//