The state's largest health insurers rejected about a fifth of all medical claims received over the past seven years, according to a report released Wednesday by the California Nurses Association.
The state Department of Managed Health Care, which regulates the state's health maintenance organizations, said it would investigate the accuracy of the data used by the union.
Using data culled from financial reports on the agency's Web site, the CNA said it found that the state's five largest insurers rejected 31.2 million claims for care from 2002 through June of this year.
"The reason they're denying them is because they don't want to pay for them," said CNA spokesman Chuck Idelson. "We need to take the profit motive out of health care, out of the decision of whether people get the medical care they need."
The California Association of Health Plans, the trade group for the state's health insurers, accused the nurses association of twisting data to fit its political agenda.
"We question the credibility of this report," said Nicole Kasabian Evans, the trade group's spokeswoman.
Insurers say there could be a number of reasons claims are denied, including being filed with the wrong insurer, seeking services from an out-of-network provider or seeking experimental procedures not covered. "In some cases, the claim might eventually be paid," Evans said.
The state Managed Health Care Department won't know how to respond until it takes a deeper look at the CNA's analysis, a department spokeswoman said.
Call The Bee's Bobby Caina Calvan, (916) 321-1067.
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