Aetna - Unforgivably Bad Claims Process - lost claims, lost payments, no follow-up from claims handlers

22 of 286 Aetna reviews

I've been insured twice with Aetna International while working abroad. While the website has evolved somewhat over time, the claims process remains absolutely abysmal.

On the positive side, the coverage was pretty solid, the deductible was low, and not much was disputed from Aetna's side.

However, virtually every claim I filed was mishandled in some way and required follow-up, sometimes five or more times for a single claim.

Sometimes all records of a claim mysteriously disappeared, and Aetna said they had no idea what had happened. In these cases, I forwarded them my confirmations of the submissions and they asked me to re-submit everything from scratch since they didn't know what had gone wrong.

In other cases, I've had claims which were processed, approved, and supposedly paid out, but can't find any payment corresponding to the date on which they claimed to have paid. When I've asked for confirmation of where the money was sent, they didn't know and said they'd have to investigate.

In other cases, payments did come through, but without a clear reference to identify which claims they corresponded to, and Aetna's own people couldn't identify which payments corresponded to which claims. This isn't a trivial problem when you're working with foreign currencies whose exchange rates fluctuate. If I submit a claim in yen or euros, it's not clear what the corresponding value will be in USD when the reimbursement reaches my US account. And since they sometimes pay out multiple claims in a single lump, this makes it even harder to identify without a detailed reference.

I've also encountered numerous cases where they messed up the claim date, leading to further confusion. Aetna International is based in the US, but forms submitted abroad typically have the date format reversed (mm/dd). One would think an insurer that caters specifically to expats would have this figured out, but no. If I visit the doctor on April 8, odds are high that they'll input it as August 4 instead.

Every time I have called Aetna customer service for help in resolving any of these issues, the staff (always in a Philippine call center) have been patient and courteous. But in most cases, whoever I'm speaking to will eventually say they need more time and will call me back and send a confirmation email after reviewing everything. Unfortunately, I never hear anything, by email or phone. There's zero accountability. In every case, I've ultimately had to call back and repeat the process until I can get someone who is willing to do everything while I'm on the phone (so if you're reading this and new to Aetna, don't let them hang up!). I've lost count of how many hours I've wasted trying to re-confirm things.

This review is a subjective opinion of a user.
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Insurance Plans Acceptance
Customer service
Value for money
Billing Practices
Product or Service Quality

  • What I liked
      No items
  • What I disliked
    • Lost of claim information
    • Payments with no ref number
    • Lack of follow-up from customer service reps
    • Online claim submission usually broken

Reason of review:
Poor customer service
Preferred solution:
Deliver product or service ordered
Review category
review #882915

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22 of 286 Aetna reviews

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