Aetna reinstates customer who made $64 error - latimes.com

Aetna reinstates customer who made $64 error - latimes.com

Los Angeles resident Stacey Owens found out after a recent doctor's visit that her health insurer, Aetna, had canceled her coverage, ostensibly because she'd missed a monthly payment.

Never mind the heartlessness of leaving people uninsured because of something as potentially trivial as a misplaced bill.

No, the problem in this case is that Owens, 25, never missed a payment -- and she has the bank records to prove it.

Yet when she confronted Aetna with what clearly appeared to be a clerical error on the company's part, Owens said, the insurer dug in its heels and refused to reinstate her coverage.
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Owens said she found out that her coverage had been canceled only after a doctor's bill was rejected by Aetna in November.

She called the company and asked what was up. Owens said she was told by a service rep that her policy had been terminated because of a missed payment for October.

This simply wasn't the case. According to bank records produced by Owens, she wrote a check for $472.99 to Aetna on Sept. 28. The check was deposited by Aetna into a Citibank account in Delaware on Nov. 1.

Yet even when Owens appealed Aetna's cancellation of her coverage and asked to be reinstated, she was told -- via a form letter -- that there was nothing the company could do to help her.

While she pressed for reinstatement, Owens said she was careful to continue mailing monthly payments to Aetna. And Aetna kept mailing them back.

Finally, Owens brought her case to me. I took it back to Aetna.

"We could have done a better job with this situation," admitted Anjie Coplin, a company spokeswoman, after reviewing Owens' file.

The problem, Coplin said, resulted from a roughly $32 increase in Owens' premium that took effect in August. Although Owens continued sending in monthly checks, she neglected to pay the higher amount for two months.

She began paying the higher premium -- $472.99 a month -- as of October. But by then, at least in Aetna's eyes, it was too late. She was short by about $64 for the previous two months combined, and that was reason enough to have her join the 47 million other people in this country lacking health coverage.

Owens said she never received advance word that her premium was going up. She said she received a letter from Aetna in October saying that her rates had risen as of a couple of months earlier. ...