California insurers deny 26% of all claims

February 25, 2011

California insurers denied 26% of all claims submitted in 2009, according to a new report.

Health insurers in California denied 26% of claims submitted in 2009, according to a report released in January from the Institute of Health and Socio-Economic Policy, a research group of the California Nurses Association and National Nurses United.

PacifiCare had the highest percentage of denials, at 44%. Other insurers studied and the claims denial rates included Cigna, 40%; Anthem Blue Cross, 27%; HealthNet, 24%; Blue Shield, 22%; Kaiser Permanente, 20%; and Aetna, 6%

These seven firms, which account for more than three-quarters of all insurance enrollees in California, have rejected 67.5 million claims since 2002, according to report, based on data from the California Department of Managed Care.