'California's Insurers Deny 21 percent of Claims'

More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, according to data released today by the California Nurses Association/National Nurses Organizing Committee.

CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, the six largest insurers operating in California rejected 31.2 million claims for care – 21 percent of all claims.

The data was presented by Don DeMoro, director of CNA/NNOC's research arm, the Institute for Health and Socio-Economic Policy, at CNA/NNOC's biennial convention Sept. 8 in San Francisco.

"With all the dishonest claims made by some politicians about alleged 'death panels' in proposed national legislation, the reality for patients today is a daily, cold-hearted rejection of desperately needed medical care by the nation's biggest and wealthiest insurance companies simply because they don't want to pay for it," said Deborah Burger, RN, CNA/NNOC co-president.

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