SF officials question Blue Shield on why it denied claims of so many retired city employees

SAN FRANCISCO (KGO) -- There is renewed focus on a retired San Francisco firefighter, whose treatment for stage 4 cancer was initially denied by the city-provided insurer, Blue Shield.

Ken Jones' experience caught the attention of members of the Board of Supervisors.

On Wednesday, a city committee convened a hearing to ask Blue Shield executives why Jones and so many other city retirees are seeing their claims rejected.

"I want to understand the percentage of claim denials. I want to understand the duration of time to respond to those claims and resolve those claims," said Supervisor Connie Chan.

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"We take members concerns incredibly serious. When we fall short, it's always moments to learn. We recognize our role and our role is to make sure we are following policy," said Tim Lieb, Blue Shield's senior VP of Commercial Markets, in response.

A retired San Francisco Police Department lieutenant spoke up about her issues getting claims approved by Blue Shield during the meeting.

"Blue Shield called UCSF and cancelled my appointment and said, 'Too bad. It's not covered. It was a mistake,'" said Miriam Pengel.

Chan said she was also disappointed in the city's health service system, for its inability to track denials and provide additional help for enrollees.