AETNA Hit With Record Fine for Denying Autism Coverage
JEFFERSON CITY, MO (September 27, 2012) -- The state of Missouri has announced a settlement with Aetna Life Insurance Company for violating the state's 2010 autism insurance reform law by illegally denying benefits. AETNA will pay a $1.5 million fine, the largest in Missouri history for an insurance law violation.
Under the settlement with the Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP), Aetna will:
•Stop issuing health insurance policies that violate Missouri law
•Pay a $1.5 million penalty, the largest in Missouri history for insurance law violations
•Notify customers that they were entitled to coverage for treatment of autism and accept claims for treatments received since the law went into effect. Aetna will pay claims with nine percent interest
•Donate $250,000 to a Missouri nonprofit organization specializing in the care and treatment of autism spectrum disorders
According to DIFP, Aetna is Missouri's sixth largest health insurance company, with premium sales of $340 million in 2011.
The state urges families complaints or questions about insurance claims or policy provisions can call the Insurance Consumer Hotline at 800-726-7390, or file a complaint at insurance.mo.gov.