These companies also outsource to middlemen companies that do some of the claim denying dirty work for them (see evicore). That’s why they all universally provide a bad service. But I have to say, Aetna is by a long shot worse than others. Look up stories of moms being denied coverage for a routine delivery. Aetna seems to regularly deny first, and then force these exhausted and vulnerable women through long drawn out appeals process. It’s just a way for them to delay payments and change their cash flow. Executives should be in jail.