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Answer: The physician is being sued. Insurance company should provide an attorney. If the doctor is negligent, insurance company should pay (that's why we have premiums). Dr. Z is sued, goes to agency, and notifies the agency. The agency doesn't notify Aetna in right amount of time, and also notifies the wrong company. Aetna doesn't have a liability because they were not notified in a timely manner. Larson is agent to Aetna. A principal's notice to agent=notice to principal. That's the same as notifying Aetna according to its claims procedure. This is not Dr.Z's problem. Aetna is wrong in denying coverage, and Dr.Z will succeed and not have to pay.
