This form for use in litigation against an insurance company for bad faith breach of contract. Adapt this model form to fit your needs and specific law. Not recommended for use by non-attorney.
Subrogation For Aetna
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How to fill out Complaint For Recovery Of Monies Paid And For Declaratory Judgment As To Parties' Responsibility And Subrogation?
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FAQ
Other ways to file claims You can also print and mail claims forms to Aetna Voluntary Plans, PO Box 14079, Lexington, KY 40512-4079, or Fax to 1-859-455-8650.
Aetna Senior Supplemental Insurance P.O. Box 14770 Lexington, KY 40512-4770.
If you receive a denial and are requesting an appeal, you'll ?request a medical appeal.? You can call us, fax or mail your information. Call: 1-800-245-1206 (TTY: 711), 7 days a week, 8 AM to 8 PM.
Electronic claims submission Use Payer ID# 128CA when submitting claims to Aetna Better Page 2 Health of California.