Aetna Loses Favorable Review Standard by Mishandling Claim

Aetna Life Insurance Co.'s missteps in denying a psychiatrist’s claim for long-term disability benefits means the insurer’s decision is subject to stricter review in court.

A Florida-based federal judge on March 1 decided to more strictly scrutinize the benefit denial because of problems in Aetna’s claims procedures. Aetna waited nearly four months after receiving the psychiatrist’s appeal to begin reviewing the case. Aetna also repeatedly delayed the review process by requesting information the psychiatrist had already provided, the judge said.

The idea that a benefits plan administrator’s missteps in handling claims could subject it to a stricter judicial review standard ...