AG to investigate claim 1 in 5 HMO claims denied

The Associated Press
6:59 p.m. September 3, 2009

LOS ANGELES — California Attorney General Jerry Brown is looking into claims that the state's top health insurers reject about 20 percent of medical claims.

In a statement, Brown says deputies in his office are launching an independent inquiry because a high denial rate suggests the system itself is dysfunctional.

AG spokesman Scott Gerber says the inquiry comes on the heels of a Los Angeles Times report that the state's largest health insurers reject up to 39.6 percent of claims.

California Association of Health Plans spokeswoman Nicole Kasabian Evans told the Times that health plans abide by contracts and there are legitimate reasons to deny claims.

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