STORY FROM: MDL Mass Tort & Class Action Monitor

Aetna Hit With Class Action for Denying Claims Without Physician Review

SAN FRANCISCO — Aetna Inc. and its affiliates have been sued in California federal court following recent revelations that the insurer is under investigation for improperly denying claims for treatment that it said were not medically necessary.

In a class action filed Feb. 13 in U.S. District Court for the Northern District of California, lead plaintiff Nichol Lundin accuses Aetna of implementing a practice in which nurses, rather than qualified physicians, reviewed health insurance claims prior to determining whether they would be covered.

“As a result of Aetna’s improper denials and lack of physicians reviewing patient’s files and records, customers ...

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