Four years ago, my wife started going through chemo. For five months, and had 3-5 different insurance items per week, almost always the same, every week. I would estimate at least 80% of all her claims were initially denied. A ton of them were denied for her doctor being out of network (he wasn't) - over and over and over. I'd fight it on one claim and they'd use the same denial a week later. I eventually threatened a lawsuit and a complaint to the insurance commissioner and that got the issues stopped.
In another case, my insurance company lied to me about coverage for an MRI. It was the end of the year and they were giving me the runaround to push the test into the new year, reseting my deductible. It worked. I had proof they had lied and got my employer to fight on my behalf and get the MRI treated as if it had occurred before the new year.
I probably have another dozen stories.
Suffice to say, there is no doubt in my mind that insurance companies do false denials as a matter of course.
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