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Aetna Insurance complaints

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15 Farmington Avenue RE6
Hartford, CT 06156 | Get Directions

(800) 872-3862

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Total Amount in Dispute:
$525.00

Total Amount Settled:
$0.00

Complaint Experience

50%

Complaint Resolution Index (CRI)

Complaint Resolution Index (CRI) Explained The Complaint Resolution Index (CRI) is an indicator on how responsive a company is in addressing and resolving customer complaints brought to their attention by BCA. If they are considering doing business with the company, consumers can use this indicator to forecast the likelihood of having their issues addressed if a problem arises. CRI measures the company's customer satisfaction abilities through BCA’s complaint mediation process.

A variety of factors are considered when calculating CRI. This includes how quickly a company responds to complaints, the number of complaints against a company, whether the company addressed complaint allegations, and the outcome of the complaints. CRI is just a subset of the overall rating for the company. Consumers are encouraged to take into consideration the company's CRI, their overall BCA letter rating and other relevant information about the company so they can make a well-informed purchasing decision.

BCA's Summary and Analysis:

Our complaint history for this company shows that the company responded to and gave proper consideration to most complaints. However, some complaints are unresolved meaning the company failed to properly address the complaint allegations or their response was inadequate.

Complaint Closing Statistics

2 complaints against Aetna Insurance closed in last 3 years.

Complaints	Type of response
0	Making a full refund, as the consumer requested
0	Making a partial refund
0	Agreed to make an adjustment
0	Refusing to make an adjustment
2	Refuse to adjust, relying on terms of agreement
0	Unanswered

2 complaints against Aetna Insurance

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12/21/2023

RESPONSE: Refuse to adjust, relying on terms of agreement Amount in Dispute: $0.00 Amount Settled: $0.00

Customer Complaint

12/5/2023

I was signed up for an insurance plan with Aetna insurance without my knowledge. Resolution Sought Find out how they got my information to sign me up for an insurance plan. I am not the only one in the building who was signed up.

Company Response

12/6/2023

Hello, Aetna has a complaint and appeal process that is available to the provider and the member. We do not respond to third party companies unless there is a clear authorization. Thanks

Customer Rebuttal

12/8/2023

My mother is 85 years old and was somehow signed up for an insurance program without her knowledge or by being manipulated by company personnel. Aetna should be ashamed of their response and pay more attention to the satisfaction of would be customers. Their response isn't an apology in any way shape or form. There should be am investigation into how they were able to take advantage of an unsuspecting senior citizen.

3/6/2023

RESPONSE: Refuse to adjust, relying on terms of agreement Amount in Dispute: $524.70 Amount Settled: $0.00

Customer Complaint

2/28/2023

I have trying for the last 4 months to get my reimbursement in the amount of $524.70. Never received by mail, email a denial for my claim dated 10/13/2022. The only way for me to know the status . Is for me to go into their site under my patient messages. I have provided all documentation they requested in the last 5 months. Now to be told by me calling Aetna the claim still has not been processed. This is unbelievable, unacceptable as I've work in the medical claims for over 20 years. And never did I have a claim dragged out when it is supposed to take 30 days from submission. I want my reimbursement now. Resolution Sought Give me my reimbursement by direct deposit not waiting on a check at this point. I've waited long enough.

Company Response

3/1/2023

Company states: Aetna has a complaint and appeal process that is available to the provider and the member. We do not respond to third party companies unless there is a clear authorization.

Customer Rebuttal

3/2/2023

How and where do I find this complaint/appeal on Aetna site? As I have tried to gain access.

Company Final Response

3/3/2023

Company states; The member may use this form and mail it to the address listed on the bottom. Thanks, Analyst, Executive Resolution Executive Resolution Team

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