Health insurers are increasingly denying medical claims: report

The rejections of prescription drug coverage among private health insurers in the U.S. have jumped 25% from 2016 to 2023, The New York Times reported, citing an analysis of over four billion claims compiled by the health analytics firm Komodo Health.

The review further suggests that claim denials have risen from 18.3% in 2016 to 22.9% in 2023, with many leading health insurers, including managed care giant UnitedHealth (NYSE:UNH), recording increases over the eight years.

Cigna (NYSE:CI) recorded the highest denial rate of 25% in 2023, according to the analysis of 4.5B claims from commercial health plans. Meanwhile, the rejection rates at CVS Health’s (NYSE:CVS) Aetna insurance arm, UnitedHealth (NYSE:UNH), and Anthem, now known as Elevance Health (NYSE:ELV), have stood at 24%, 23%, and 22%, respectively.

However, Humana (HUM), the only insurer to witness a drop in denial rates over the past two years, has indicated a 20% rejection rate.

The report comes at a time of intense public scrutiny over the health insurers’ medical claim denials, with the words “depose,” “deny,” and “delay” mentioned on the bullet casings found at the scene where Brian Thompson, former CEO of UnitedHealthcare, was shot to death in December.