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Strategies & Market Trends : Aetna ( aet)
AET 212.70+0.3%Nov 28 4:00 PM EST
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To: George C. Grasser who wrote (65)7/7/1999 4:57:00 PM
From: Logain Ablar  Read Replies (1) of 110
 
George:

This is not a fraud against the insurance company or at least not based upon the way you outlined the facts.

I beleive you may not understand how a health policy works (and there are many types and the following comments are not all encompasing). It is the employer who contracts with Aetna, not you, even though you may have chosed Aetna over another plan provided by your employer (you'll need to read the actual contract to see this).

Your first order should be to work through your employer channels (risk management, employee relations, union representative, personnel, etc., not your direct boss) to correct this inadvertent error. Aetna legally could not drop the individual unless properly notified by you thru your employer.

If you have a valid complaint the company will handle it. As a last resort you can write the chairman, Dick Huber @ 151 Farmington Ave. and his office will respond. Aetna will end up contacting the company representative and it will be brought to your employers attention that way if you go through Aetna (just another cost by Aetna that has to be born by shareholders and policyholders).

If there was an actual defrauding of the company the internal audit department would be the right contact. Right now it sounds like they are just trying to help a customer (but its your employer who is the direct customer). Also if you write the letter and start like this post I doubt if the response will be to your satisfication.

Good luck.
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