Frankel & Newfield, P.C.

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Recent News Archives

IS AETNA'S DISABILITY BUSINESS AS TARNISHED AS ITS HEALTH INSURANCE?

In a stunning admission, a former medical director for Aetna admitted, under oath, that he never looked at patients' records when deciding whether to approve or deny care, according to an exclusive news report from CNN. Dr. Jay Ken Iinuma, who was medical director for Aetna from March 2012 - February 2015, made this admission during a deposition in an insurance coverage lawsuit.

IS AETNA'S SALE TO HARTFORD BEHIND ITS CLAIM HANDLING CONDUCT?

A recent decision by a Federal Judge in North Carolina supports such a line of thinking. Here, the Court determined that Aetna failed to properly consider subjective evidence (a common theme of Aetna), as well as providing "scant attention" to the supportive medical evidence. Here, the claimant, a commercial pilot, was suffering from significant orthopedic problems, supported by testing results. Aetna denied the claim, asserting that the medical evidence did not support the inability to perform the material duties of his own occupation. Despite significant additional medical evidence being submitted on appeal, Aetna continued to refuse to accept liability.

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