CALIFORNIA -- Ok everyone listen close. After my husband was denied for "any occupation" I got a copy of his administrative file. You must do this right away. Even if it's been awhile. Then I called the doctors that did his peer review. I found out in his file is a copy of exactly what Cigna had sent him to review. They had held out the most important papers that would have deemed him disabled for the entire time until age 65 (as they say when they sell the policy to you).
Now when I found this I called them back because this was my final denial and civil court was next. But when I reminded them that in 2013 there was 77 million dollars charged to them for holding out evidence they suddenly agreed to resend that record file back to the same doctor so he could see it all. And in between I let the doctor know that I didn't understand how he could make such a drastic decision without knowing everything. Must have got something going because he called Cigna and let them know I had been calling.
Anyway it takes hours of research and time because those files are about 1200 pages but I will give you my email and I will help anyone. My husband was a loyal employee for 21 years and has awards for 9 years straight with no days off. He paid for this and he is entitled to this. He has spinal stenosis from work and will need lots of care in the future.
PENNSYLVANIA -- Shame. Cigna - The C is for Cowardly. The I for Inhumanity, The G- for Gutless, The N- for Nonchalant, The A-for the Administrators. I would like to take a moment to say 'Thank you' to my insurance company (Cigna), they truly believe in their mission to serve the community by providing excellent healthcare and supportive services to their 'Financial pockets', excuse me, I mean to their clients in their time of need.
I was diagnosed with glaucoma, cataracts and a host of other eye diseases at the age of 19. After many years of battling the diseases, I lost the battle and had an enucleation of my left eye. Through all my trials and tribulations I went on to successfully serve the public (working) for past 30 years. I went back to graduate school and received my Masters degree and I had the privilege and honor to work in the community in the health department until I became unable to work in September 2015.
I begin to experience visual difficulties with my sole remaining eye. The ophthalmologist along with my primary care physician restricted all my driving privileges. My vision was measured at 20/400. My inability to drive severely impacted my professional career as a Social worker, my personal life and my personal freedoms. The inability to drive myself to the supermarket, work, or the doctor was life changing. It was life-changing and extremely depressing. Not to mention the psychological impacts and the fear of losing my sole remaining eye.
Instead of being able to seek the medical services that I need without worry, I have had to spend hours trying to gather information for Cigna from each and every doctor that I have seen during the last month. During the month of September, I applied for short-term disability through CIGNA. This has been an extremely humiliating experience. My time is filled with anxiety, depression and worry.
I have spent hours contacting the receptionist at the doctors office attempting to get them to give the form to the doctors to complete as they provide services to the hundreds of other patients on their caseload. A Cigna representative that I spoke to on Friday, October 16, 2015, advised me that she sent the request to the (Neuro-ophthalmologist) office three times. Commenting that they have failed to respond to their request. I question the need for the same form to be completed when the form was just filled out the previous week before by two doctors, a licensed ophthalmologist and my primary care physician.
It appears that if I see 20 doctors in one week the form must be completed by all 20 doctors. I pondered why is it that the medical records which contain all the information they need does not suffice. My desire is to concentrate solely on my healing and well-being not on whether or not my short-term disability will assist me in my time of need.
I have been examined by four physicians. The doctors are as follows: my primary care physician, two ophthalmologist and one Neruo-ophthalmologist. They are all attempting to determine what is the cause of my blindness. The condition has not changed or improved as the doctors case notes specify that information.
My last appointment was October 14, 2015, with the Neuro-ophthalmologist. I was referred for an MRI. My follow-up appointment is November 2, 2015. There has been no change in my vision and the MRI is the next step. The short-term disability department was provided information from my primary care physician and the ophthalmologist. Each of the four physicians have been required to submit their case notes which I have no problem obtaining. The issues have been the filling out of the disability claim form from each and every physician.
I would like to paint a picture for you. Close your eyes (that's my world, darkness) and imagine that after meeting a physician for the first time you walk through the door with a form for them to complete for disability. Charming approach at building a rapport in the doctor and patient relationship. I'm blind, I'm scared I don't know what's going on with me, but please complete this disability form so I'm not eating cat food and I can still pay my rent.
The information that Cigna is requesting for 'a diagnosis' is not available at this current time due to the circumstances and the need for further testing. I had my first appointment with the Neuro-ophthalmologist on October 14, 2015. They requested and forwarded the request to the Neuro-Ophthalmologist on October 1, 2015. I had not even had an opportunity to step foot into his office and they were requesting that he complete a disability form on the patient that he had not examined. They requested he complete the form two weeks before he even had the opportunity to examine me.
I would like to add this very important fact: this particular specialist is one of two in the area and he squeezed me in for this appointment because my previous doctor asked him to do this as a favor so I could avoid the six-month waiting list based on the fact that I am a single vision person who has had numerous eye disease in the past. The only thing that a patient can take from this type of behavior is that Cigna is trying to deny my short-term disability by inputting wedges and making it very user unfriendly for clients in their time of need.
Humanity, dignity words of encouragement, those are not the services that I have been provided by Cigna. Instead, I have been made to feel like the dribs of society and that I am begging for crumbs for my very existence. The amount per week of my premium should be $641.09 which amounts to 67% of my biweekly salary.
Today I have received two weeks pay at the rate of $641.00. The finally letter from Cigna date October 11, 2015, gracefully assuring me that there would be no future checks based on the lack of documentation. Thank you for the reality check. I'd like to end with the painful truth that I hope will help others who may find themselves in a similar situation after paying thousands of dollars for my insurance premium for over a decade. If I would have invested the money that I paid Cigna, I would have been investing in myself.
CHATTANOOGA, TENNESSEE -- I keep getting EOBs (Explanation of benefits) from Cigna for medical services (colonoscopy, heart monitor, pathology of polyps) that Cigna does not pay one red cent towards. Yet we pay them over $4,800 a year for medical "coverage" that doesn't "cover" ANYTHING??!! That is the biggest scam I have ever heard of and it should be illegal!! Just the amount of money they rip off from us for premiums would cover the amounts I owe on 2 of my medical bills, so what good is health insurance doing me????
MOOSIC, PENNSYLVANIA -- I left Cigna on 9/7/13 (gave 2 week notice), they sent my last check to me. However on Monday 12/2/13 I received a letter stating they overpaid me by almost 800.00 in PTO days... they want payment in full by 12/12/13. I am so furious that it took them 3 months to figure out that they overpaid me which I request proof of my PTO days that I took and what I was allowed and it will take 7-10 business days. How dare they do this to me. Is there anything I can do about this if I do owe them the money?
I was recently employed with this company and was also a customer. As soon as they found out I had been diagnosed with and was in active treatment for PTSD, they engaged in such severe discrimination that I was eventually forced out of the company. I have been asked why I don't sue. I know the EEOC is an option, and though I am going to the EEOC, this company has almost unlimited resources and I double the EEOC will pose much of a problem for them. They also have mandatory binding arbitration which one must agree to as a condition of employment. Long story short, they can freely engage in discrimination and get away with it.
LOCKHEED MARTIN CORPORATION -- Where to even begin? I have been fighting Cigna for 4 long years regarding my short and long term disability insurance. Like others who have testified on this site, my benefits were abruptly shut off and then I experienced a continual denial on each appeal for various different reasons starting with "We don't doubt that you have suffered from various medical problems, but believe they do not constitute total disability" to that of a "preexisting condition". Cigna utilizes an in-house nurse to rubber stamp rejections as their supposed medical review process.
I suffer from Interstitial Cystitis, Fibromyalgia, Depression, IBS, Degenerative Back Disease, Vulvodynia, and Migraine Headaches. My medical records contain letters from 4 different urologists that state I must undergo long term narcotic therapy for chronic pain due to an incurable disease which causes intractable pain. My pain management doctor has attested to my inability in maintaining employment due to both physical and psychological limitations.
Like others on this site have stated prior to my review, Cigna ignored my doctors reports and medical records which declared me disabled. They also ignored the fact that the Social Security declared me disabled and incapable of any performing any occupation. In addition, Cigna has never even requested a physical examination performed on me by a doctor of their choice.
I appealed Cigna's denial decision to the State Medical Board. The State Medical Board required Cigna to have an "outside" (Cigna paid) medical doctor review my case. Cigna's doctor reviewed my medical records. There is no surprise that he denied my claim. The doctor was blatantly unfamiliar with my primary disease (IC), and he could not even read my diagnosis reports. The State Medical Board could not require Cigna to pay my claim, and they suggested that I hire a lawyer and take legal action against Cigna.
I hired an attorney who works on a 40% retainer with $400 down. At this point, Cigna came through with a chump change settlement offer which I declined. Cigna only offered to pay my entire claim/policy off for just 2 years of payments which would constitute the lookback period of whether I can work "any occupation". The case is now in court awaiting the judges decision.
According to the policy, the question to the court now is not whether I am disabled, but whether Cigna's administrator was "arbitrary and capricious" in making their denial decision. Of course they were "arbitrary and capricious" in their decision. but this is huge hurdle to prove and really irrelevant, I am disabled and deserve my money.
From reading comments made on the reviews posted, the majority of people do not understand their employers disability policies or ERISA law. You cannot sue for or collect punitive damages (pain, suffering, mental anguish) against the insurance company. You may only collect what is due to you under the policy adjusted for cost of living and interest. That includes the fact that I cannot recoup my doctor and prescription costs which I paid out of pocket during the 4 years that my insurance and prescription benefits were also denied. With all this being so, there is absolutely NO incentive for Cigna to pay ANY claim.
WARNING: Therefore, it is best NOT to pay for disability insurance through your employer (which falls under ERISA laws), but protect yourself and family by buying outside independent insurance. Paying through your employer is just flushing good money down the drain. DON'T DO IT.
At this time, I am hoping for a favorable ruling from the court. If so, as I state above I will be out 40% to the lawyer and will not recoup any out of pocket doctor's office or prescription expenses occurred over the past 4 years. My lawyer has informed me that if we Win the case he expects Cigna to appeal. My lawyer has also told me that if Cigna appeals he will not continue to work the case on a contingency basis but need upfront payment.
This entire process of dealing with Cigna has been a nightmare. I have exhausted my 401K in medical bills and living expenses. FYI-God forbid that you should ever find yourself in a similar situation. If so, my best advice is to ask for a copy and review your disability file from Cigna regularly. Make this request in writing sent certified. You will find that Cigna purposely omits information that bolsters you case, and Cigna purposely inserts information that makes you appear unavailable and unresponsive to their requests.
This employer insurance is a SHAM and need serious reform. I am at a loss as to why this is not covered in detail by the media and news programs. Someone somewhere is making BIG money and must be paying others to keep hush. You have now been warned. Consider yourself lucky and protect yourself and your family appropriately.
P.O. BOX 696018, TEXAS -- BEWARE SENIORS OR ELIGIBLE MEDICARE RECIPIENTS!!!! Check Medicare vs. Advantage replacement plans before you sign up!!! They will offer you "fluffs", and you will pay more out of pocket than original Medicare!!! Cigna's Medicare Access Plan (PFFS) 2010 does not pay for some medications that have to be administered by a physician in their office. Cigna states that the medication (medical Botox) has to go through their Part B; they gave me the run-around. I have been told more than 4++ (I lost count) different excuses from Cigna.
Here is their latest "Mumbo Jumble" that was stated by a company representative (SUPERVISOR) in Arizona: "Yes, we do cover the ADMINISTRATION of medically necessary medications MEDICARE PART B-but, you must meet your $3,000 deductible; any and all the co-payments that you have made throughout the year do not count." I reminded that their contract stated that an individual on their plan is only responsible for a $20.00 co-payment for a specialist MAXIMUM. Then, ** stated that Part B was separate from a regular office visit for the administration of the drug.
CIGNA insisted that I had to get this drug from their pharmacy (covered under "Argis-I am guessing their preferred drug company ‘Medco' uses this pharmacy.”). First, Cigna's Part D called and told me I would have to pay $241.00 out of pocket. Then, they called back and stated that the cost would be $999.60 out of pocket.
Again, Cigna called and stated that the drug would cost $940.00 out of pocket. ** called and stated that she could get the drug for $760.00, but... I still did not meet my $3,000 out of pocket for the neurologist, so, I would have to pay for the drug and an out-of-pocket expense for the doctor to administer it (they told the Botox Assistance Programs that they were going to pay for it). I called Medicare; they told me that if I had regular Medicare after I met Part B deductible, that my cost would only be 20%. Medicare stated that these replacement, access, etc. could make up their own rules without government regulations.
Now, I had to reschedule my appointment for December 21st, 2010 until after the January 1st, 2011, when regular Medicare kicks in. I am in so much pain that it is difficult lying in bed to type this. My neck, face, jaw, and eyelids are in painful spasms. I have had surgeries, pain management without any relief. I am a disabled RN due to a patient assault. I thought Cigna was a good company; I should have googled them instead of trusting them prior to signing up with them (I was ill when I signed up with them, and I was not thinking properly due to serotonin toxicity).
As a nurse (although disabled), I believe it is my duty to warn our senior population and disabled individuals, so that they do not end up paying more out of pocket expenses that regular Medicare (Please note: I paid CIGNA $95.00 monthly + Medicare Part B premiums + co-payments; this equals-MORE than REGULAR MEDICARE).
NEW JERSEY -- On 11/24/2009 I had a medical procedure that amounted to $10,779.00. I was informed that this procedure was covered my Cigna insurance. On 01/27/2009, the service provider sent me a letter that was addressed to an incorrect mailing address. The letter stated the Cigna send a notice to the provider on 12/18/09 that they are not obligated to pay any portion of the claim because of the provider's waiver of co-insurance and deductible. For years, this provider had wave co-insurance and deductibles and was notified of the Cigna change after my service were provided.
About 2 months ago, I was contacted by a collection agency demanding payment of $10,779.00. I called Cigna on 6/23/12 and was informed that it appeared that the claim was denied incorrectly and was scheduled to be re-opened and to call back in about 15 days. On 7/5/12, I did a follow-up call and was informed that the claim was being reviewed. On 7/23/12, I called again and was informed that claim was active and call back in 15 days. On 8/8/12 I placed another call and was informed that a service representative call and informed me that I would have to file an appeal due to the claim is now over 2 years old. I am now appealing the claim and awaiting disposition.
Meanwhile, debt collection company is now calling and for payment. I am trying to hold the off because I am on fixed income and no means to repay $10,779.00 to repay this amount. Now they are possible reporting this on my credit file and at 68 I may have to file bankruptcy to get out of the debt.
EDEN PRAIRIE, MINNESOTA -- I'm have been on Cigna as insurance for 8 months. I have been with the same therapist for many years, using the insurance plans offered through the companies I've worked for. I suffer from mild depression and working with a therapist has helped my quality of life immensely. I recently received something in the mail from Cigna.
A letter that begins: "Have you recently experienced trouble concentrating or sleeping? Are you feeling overwhelmed, anxious or withdrawn, or having difficulty adjusting to a major life change? Did you know there's a free service through your medical benefits that can help you manage your symptoms? Recently, a claim we received from either your doctor or pharmacy, or information from a health assessment you completed, has helped us identify you as someone who may benefit from this program."
I am feeling completely violated by this. I have never had an insurance company feel they were entitled to step in and comment on my private health information or assume they were qualified to inject one of their staff into my life to comment on personal health issues. It's like a new level of intrusion. How could this possibly be in compliance with HIPAA?
My expectation is that an insurance company can approve or deny claims, not that they can administer care or provide health care advice. Cigna has taken my health care information--either privileged information that I share with my doctor or specifics of medications that I have been prescribed, and run it through a marketing program that would identify me as someone they could put into a bucket for solicitation about a mental health "coaching product" they offer.
I'll be taking this up with my doctor as well as the attorney general about privacy and legality. I can't just let this end with Cigna pushing the envelope with methods that are intended to intimidate patients into ending medical care that is of a highly private nature. I'm sure it would be quite convenient if Cigna could get me to end my therapy with a qualified physician with whom I've been working for years, and call their free "phone coach" for therapy instead, but this is totally unacceptable to me.
I don't want Cigna to monitor my private health care and diagnoses and offer me tailored marketing based on their business objectives. I pay my premiums, percentages and copays and am entitled to proper medical care. So I have two choices: 1. End my care so that they no longer have access to my private health care information and diagnoses, or 2. Fight back and tell Cigna that I don't want them using my private health care information and diagnoses for anything other than a yes/no vote in their claims system. Knowing that my disapproval with their policy won't be enough to bring about change, I have no choice but to bring this issue to a wider audience.
11095 VIKING DR., SUITE 350, EDEN PRAIRIE, MINNESOTA -- I am dropping Cigna as soon as I can because its service has been appalling. I have been submitting claims since February 2010 and never once have I received the amount of reimbursement that I was promised (70% of Reasonable and Customary for an LCSW in 20912=105 out of 150); it was solely on the basis of that promise that I chose Cigna. I could not make up the nightmare this company has been. I have met every possible roadblock: one claim was denied based on my mistake of copying the diagnosis code incorrectly from my provider's itemized bill to my itemized bill—BOTH itemizations were included with the claim, however.
I have been repeatedly denied full reimbursement (70% of reasonable and customary for out of network) because initially my provider was in an affiliated network, without knowing that that was still active (or that that affiliation with Cigna even existed). He has since TWICE provided documentation that his association with that affiliated network was ended AS OF 1 March 2010, and still, as of this date, I am being told that Cigna has no record of this change having been made. I have had to call twice monthly and each time explain the entire situation because apparently no record is made of my calls.
I am convinced that Cigna is deliberately blocking my access to reimbursement, and thus to ongoing health care provision, in order to frustrate me out of pursuing my claim. I will not only not renew my policy with Cigna, but I will tell all my family and friends and everyone else I meet that Cigna is just a typical Insurance company whose SOLE concern is its own profit, and who is willing to sacrifice anyone's health and well-being to its bottom line. I will also continue advocating for socialized medicine and the abolition of all such companies as Cigna.
The only recourse the U.S. has to such abuses is to nationalize health care and place limits on the unprincipled actions of those who believe that capitalism is an ethical system entitling them to exploit and abuse those who have physical and mental illnesses.