CIGNA Corporation - Page 3

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Medical Claim denial
Posted by on
DALLAS, TEXAS -- I was diagnosed last year with a hole in my heart. I have three doctors that have indicated that this procedure is medically necessary to my survival. My doctor has spoken to the medical director, wrote letters outlining why this procedure is medically necessary and sent all the required documentation to support that the procedure is medically needed. Every time I tried to get an update on the status on my claim I receive a different reason for its denial. One time it is there is not enough documentation to support that it is medically necessary. Next time I am told that this procedure is not fda approved and considered experimemtal. I found out a week ago that cigna approved the same procedure for another cigna patient.
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tnchuck100 on 01/30/2011:
They may continue denial until they see some legal heat headed their way. You can bet they are hoping you will just give up and go away. I would at least consult with an attorney.
Anonymous on 01/30/2011:
Just because a procedure is ordered by a doctor doesn't mean your insurance company will cover it. Have you looked through your benefits brochure to see if experimental procedures are covered?
Anonymous on 01/31/2011:
I have had some experiences with Cigna. Both when I worked at a medical office and also from my own personal experience. They deny things that should be covered all the time. You have to appeal and appeal. I truly believe it is a delaying tactic they use on everyone. Don't give up. If you can provide proof that they paid for the same procedure for someone else, provide that information to them. If that doesn't work, the next step is your insurance commissioner. I dealt with many insurance companies and found that Cigna was one of the worst for paying valid claims. They were also notorious for giving different info every single time you called.
leet60 on 02/01/2011:
Despite what many believe, claims department representatives at insurers are paid to find a reason to deny everything possible. They are not on your side. I agree with tnchuck100, you need to throw some legal heat their way.
rosieposie25 on 03/17/2011:
Thank you all for your advice. The stall tactics that Cigna is using is not going to work. They will be getting a lot of heat coming there way. I am going for broke which means Cigna out of business.
rosieposie25 on 03/17/2011:
Let me know if any of you have figured out which tv stations,newspapers and or radio stations that are not bought off by cigna and are willing to expose them for the crooks they are please send me a message. Thanks
rosieposie25 on 03/23/2011:
I was turned down today and this was my second appeal. Please everyone continue fighting for what you believe in, Cigna thinks it is over but I will never stop fighting and neither will my husband so I hope they are ready to go out of business
Anonymous on 03/23/2011:
Good luck, Rosie.
rosieposie25 on 03/25/2011:
Thanks Nicole
rosieposie25 on 04/02/2011:
I just mailed in the final external review for Cigna. This review is done by people not associated at all with Cigna. My feeling is when someone has something that needs to be done or a treatment that is needed than the insurance company needs to just pay it. Especially since we are paying the high premiums, The outcome affects the patients and their families' lives not the insurance company. So the decision to have the procedure I need done should be between myself, my family and my doctor and no outsiders like Cigna,
rosieposie25 on 12/25/2011:
I never gave hope as I continued to fight for what I believed in. Now I had the procedure done and I am doing well.
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I have Cigna OAP. Do I have any recourse when a Cigna Rep verifies a coverage to a Doctors office and later, Cigna says that...
Posted by on
TEXAS -- In June 2009 a Bariatric Surgeon's office staff, on my behalf, called Cigna customer service to find out if Bariatric Surgery was a covered benefit. The representative verified coverage, stating that Cigna would cover Gastric Bypass or Lapband, but not Gastric sleeve. She told the office lady that I had to wait six months, and in that time I had to complete several steps, which included attending a monthly information "class" on diet, nutrition, behavior modification and exercise. I had to have a psycheatric evaluation done. An EDG(?)...upper GI...was done as well as a sleep study where it was determoned that I had Sleep Apnea and needed to sleep with a CPAP machine. All of the claims for all of these tests and procedures were paid by Cigna. That have spent over $7000 and my copays amount to over $500. I completed every requirement, jumped through every hoop. Last week I received a call from the doctor's office representative She stated that she had called Cigna to submit all of my information in order to get the final approval and pre-certification and was told that my plan did not now nor had they ever covered any bariatric treatment. They showed record of the call in June, but it did not state one way or the other whether their representative verified coverage or not. The new representative "apologize" for the error and said she did not know why the previous repwould have verified I am out all of my co-pays and Cigna has spent all of that money for me to have a procedure that they will not pay for. Why would they pay a Bariatric Surgeon for classes on weight loss etc if they do not cover any type of weight loss treatment? Why would they pay claims for tests ordered, not by my primary physician, but by a Bariatric Surgeon? Anyone have any experience with this sort of thing? Any advice? Would it be worth talking to an attorney? Any way to force their hand? Can I request that they listen to the tapes of that original call to see that the representative verified coverage? (in case it is the doctor;s offic mistake, which I doubt, because Cigna did pay the claims...) Any help is appreciated!
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BEJ on 03/10/2010:
Unless you have an authorization in writing from the initial call--there may not be much that you can do. I would file an appeal with the insurance company. Have all of your information--the test performed and the phone call information. Escalate this up the chain of command. They may have had a change in what they cover but you need to file that appeal.
Blessedintx on 03/10/2010:
Good advice. Now, do I file an appeal or does the doctor's office do it?
Blessedintx on 03/10/2010:
So sorry, meant to include a sincere Thank You for your response and advice, BEJ!
goduke on 03/10/2010:
I believe that Texas insurance law is that if they quote you a benefit, they are bound by it. You might want to contact the Texas Dept of Insurance.
BEJ on 03/10/2010:
You should file the appeal with the insurance company. Sometimes the denial is made because they want more information from the doctor. You could also have the office call and see if a MD to MD peer review would be helpful. Still I would have you call and file a grievance to get the process going.
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An insurance nightmare!!
Posted by on
KANSAS CITY, MISSOURI -- I am so glad I found this site! I am ready to spit nails I am so mad at this insurance company!! I do not claim to fully understand insurance companies, and rarely go to the doctor, but never have I had such a poor experience with an insurance company!
This week, I made an appointment to see a doctor for an outpatient procedure/diagnosis at a local hospital. I went to the first appointment and everything was fine, scheduled to return the folloing day for medications and treatment options. Well, I return the next day and the financial office representative comes to speak with me on payment options!! I explain to her that I have insurance through my husband's place of work, and his employer pays a percentage of the deductible before it ever reaches the insurance. Well, the representative looks into it, and can't find any such info, so I am stuck paying 1450.00 out-of-pocket, when I am supposed to be INSURED!!! My husband was told and he is trying to make sense of it through his employer, and told me not to worry. I then go to fill my prescription, and am told that they need the Dr.'s authorization to use the genereic form instead of the name brand. It was only for a 30 day supply, and nowhere on our info does it mandate that we MUST have the generic, or nothing at all!! Needless to say, a medicine I was supposed to begin today, can't be picked until maybe next Tuesday at the EARLIEST!!! I am soooo upset!! This company is a JOKE!!!
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Doctor Charlie on 12/10/2009:
It sounds like you have no understanding of what your insurance coverage is.

Is this provider in network? Do you need a referral? Do you have a copay / coinsurance? What percentage is covered? Is this for a covered service?
BEJ on 12/10/2009:
You need to check what is covered by insurance. Some insurance plans only cover generic medications. If it is not a generic and you opt to go with the brand name--you have to pay full retail price. The pharmacy cannot switch you to a generic version of the medication without the approval of the physician. As far as the procedure goes--if it is not a covered benefit or you go out of network or the physician is not in network--etc your copay portion will be larger. Did you check to see if this procedure was authorized by your insurance company before you went ahead and scheduled it
joshvhawaii on 12/19/2009:
Your right, you really don't know about insurance. Before you go off on the insurance company, why do you pick up the phone and find out your BENEFITS! It sounds like you have a deductible to met, and then CIGNA will pay a percentage of the rest. So if you have a large deductible (which you employer built) that sounds about right! As far as your RX is concerned, that's not your insurance company, they are trying to save you money take it up with the pharmacy!
1103kenzie on 03/01/2010:
Well I can personally say that I have had no problems with Cigna. One of the members on my plan has multiple types of arthritis and just one type of the medicine she receives is $4,800 with insurance coverage it is only $45. We don't need referrals which was especially nice when my daughter had to get an EKG done and the doctors sent us to an adult diagnostic place that said she was to young we just decided to go to a different place. We went to a doctor that wasn't covered by our insurance and a few months later receiving the full bill we called the insurance company and we didn't pay but the $15 we have to pay to see any of our doctors. We have full coverage on medical, dental, and eye. We also can get generic and un-generic medicine without penalty. So I have no problem with Cigna and I would recommend it to anyone who asked.
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CIGNA gives different answers every time you call them
Posted by on
I and my doctors office called CIGNA and CIGNA Telepharmacy over a period of two days and were told the following by various associates:
1) My daughter had not been covered for prescriptions since August 2009.
2) My daughter was covered for prescriptions and still is, but the injectable medication is not considered a prescription (although you need a prescription to get it)
3) The injectable medication could be covered under "Medical" but only if purchased through CIGNA TelePharmacy.
4) The injectable medication would have a co-pay of $20.00 through CIGNA TelePharmacy as for a prescription even though the terms of the policy indicate it is not a prescription. No deductible would apply.
5) The injectable medication would be covered under "Medical" and the associate did not know if a deductible would apply or if co-pay would apply.
6) Last answer - If the injectable medication is delivered to my home by CIGNA TelePharmacy there is no coverage under CIGNA. However, if the injectable medication is delivered to the doctors office, then the doctors office could bill CIGNA and the deductible would be waived.

Who knows what the truth is, except my daughter does have prescription coverage, for all the good it does her in this situation!
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kimberlie on 05/20/2011:
I have come to the conclusion that Cigna employees get paid only if they avoid answering a question correctly.
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Be very cautious when enrolling in a CIGNA plan
Posted by on
PHILADELPHIA, PENNSYLVANIA -- I was at one time a participant in a CIGNA HMO, and the experience was a nightmare. I was referred by my family physician for surgery, and the procedure was approved by the CIGNA office in my area. I took three days off from my job, hired a driver/companion, since I was having anesthesia, and booked two hotel rooms at the hospital three hours away. I arrived at the surgical suite at 6:00am, since I was first on the schedule, and the attendant informed me that CIGNA had cancelled my operation, because they had "made an error" in authorizing it. I then guaranteed personal payment, and I was added to the end of the day's schedule, which caused a 9 hour wait. Upon my return home, I filed a complaint and a lawsuit, and settled, but it was insufficient compensation for the stress and interference that CIGNA employees delivered. From that point, I paid all of my medical expenses out of pocket, until an enrollment period when I could change to another company. I was afraid CIGNA would continue to make errors and cause problems. Interestingly, I never received an explanation or apology. I always recommend to colleagues that they stay as far away from this company as posssible, unless it's the only thing available. If that is the case, I advise them to prepare for confrontation, to record all conversations, and to keep records of names, phone numbers, and all correspondence. Most have thanked me later.
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clutzycook on 11/29/2009:
Nice that you were able to afford to pay for your medical expenses out of pocket. Not many people are able to afford to do so.
Anonymous on 11/29/2009:
You're in PA, so why not choose another insurance, such as Highmark. Cigna is one of the more limiting health plans, especailly if you're under an HMO. And you should be grateful you got any amount from a settlement
Suusan B. on 11/29/2009:
I have Cigna EPO in California and have had absolutely zero problems. I had surgery in September and it went very smoothly and only cost me $35 co-pay for the surgical center - - the surgeon was covered 100%.
mrs1140 on 12/21/2009:
Saintpete, thanks for sharing your experience. My family had Cigna PPO a while back and it was nothing but trouble. We had to constantly call, send in claims 2-3 times, and then pray that they'd pay the bills.

But what happened to you is criminal. As to what littleyaya said, you don't have to be deserved that settlement. Good for you.
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Nothing but problems with Cigna
Posted by on
Ever since my husband's company changed their insurance healthcare plan to Cigna, it has been nothing more than problems with this healthcare insurance company. I am forever calling our Health Advocate for help paying the claims. This is always after several times of talking to Cigna's customer service reps. This is not an HMO Plan but their Open Access Plus Plan where the company pays $1500 monthly for this insurance. One would think, $1500 a month would give you some decent service. Not the case with Cigna.

I will be pushing to have the company change insurances at the next renewal and hopefully Healthcare reform will do something about companies like Cigna who seem to care about nothing more than their bottom line. We were happy with Great West Healthcare, our prior insurance company now acquired by Cigna. I understand now how this was feasible.

What a shame for our healthcare services in America today!
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MSCANTBEWRONG on 08/26/2009:
Don't count on healthcare reform to help with may just make it worse. Keep after them...eventually they pay the claim. They just like to delay as long as possible. Good luck!
Anonymous on 08/26/2009:
My best friend is having her own fiasco with Cigna right now too. She had foot surgery and Cigna was supposed to take care of her short term disability. They claimed they mailed her out 3 checks when she only received one. She's been through hell trying to get them to pay up. Good luck!
jktshff1 on 08/26/2009:
I would highly suggest that you let your husband handle this with his company..just tell him what to say.
Suusan B. on 08/26/2009:
I currently have Cigna Open Access EPO and have never had one single problem.
TJLambert on 07/21/2011:
It's highly certain Cigna is not delaying payment to save themselves money. There is probably a documentation issue with the claim, attachments or even the way the benefit is described. I'd suggest you file an appeal with that unit within Cigna. Ask their customer service rep for that address and what their appeal process is.
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Medication Refill
Posted by on
For 2 years I have been receiving my birth control pill ortho-tri-cyclen lo through home delivery service. I recently had refilled my order and I was sent the generic drug ( Tri-Lo-Sprintec) versus the brand name Ortho-Tri-cyclen lo. As you must know, I was very upset because that is not what I wanted. In the mean time, I wanted to go get the prescription refilled at my local pharmacy until I straightened out the matter with the pharmacy delivery service and my doctor's office. I was told that the brand medication is no longer available to be through refills by a local pharmacy, the only way I can receive the medication is through the home delivery service. I think it is bull ***** that patients do not have the option to be informed ahead of time that their prescription will automatically be sent as a generic when a generic version becomes available!!!! Cigna is ridiculous and I hate this insurance!!!!!

How do they have they say so to tell you where and where you cannot get your prescription refilled. Prior to even starting the home delivery service, I used to get the ortho-tri-cyclen-lo refilled at my local pharmacy and now 2 years later that option is no longer available? Cigna sucks and I am also going to write a complaint about the home delivery pharmacy as well!!!!
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skelly39 on 08/04/2009:
There is no difference between the brand name and the generic. If you had no insurance, would you pay more just to have a brand name? Most policies have a built-in clause that if the generic is available, that's what you are going to get. Be happy you have insurance and can get medication.
goduke on 08/04/2009:
You really ought to discuss generics with your doc and/or pharmacist. For many folks, they achieve the exact same thing and you can't tell the difference. The big pharma companies want you to buy into the belief that only the brand will do the trick because it puts cash into their pockets.

You'll also find that because the generic is now available, your co-pay for the brand is going to go way up.

And since the insurance company and/or employer are paying about 80% of the costs of the brand meds, they have every right to say where you get them.
Suusan B. on 08/04/2009:
If a generic is available and your doctor doesn't check the "Do Not Substitute" box on the prescription form your medication will be filled with a generic. Furthermore, as soon as a generic is available some insurance plans won't allow policy holders to get the branded form and if they do they are going to charge you a fortune. Read the terms and conditions of your pharmacy plan on and it will make it clear to you that the insurance company does have the right to regulate the prescriptions you receive, where you can get them, whether they are brand name or generic and what you will pay. I believe in this case Teva Pharmaceuticals and Ortha McNeill have settled their court case and Teva is now providing the generic for your birth control pills.
misspink on 08/05/2009:
Skelly39, goduke, and Suusan B,

I will receive the brand birth control pills that I WANT, what is the purpose of this website if people can't write their opinions? I will receive the brand name and I will continue to pay the same price for them as I have always been doing. My doctor wrote a new prescription for the brand name only. I am just writing how I feel and how I think things should be. If the patient has been on a medication and it works fine for them, and the doctor agrees. Then who is the insurance company or anyone else for that matter to tell them that they will be switched to something else. This is just me stating how I feel, I saw another person on this website complained about Cigna changing their blood pressure medicine from their brand name to a generic brand, and they prefer the brand name because it works so well for them. If you find a medication that works well for you, I believe that you should be able to keep taking that brand. There's side effects to all medications, I didn't even get any from the brand that I am on, why do I want to experiment and try something new that may or may not give me any issues. Some other brands of birth control pills have some cases where people got blood clots from them. I haven't experienced no problems with the brand I'm on and for now I can keep receiving the brand name, so I'm pleased with that.
Anonymous on 08/05/2009:
It's unfortunate but a fact of life that the insurance company does not have to cover the drug you 'want'. If you refuse to take anything but that one, you'll end up paying for it yourself. The days of having any and every prescription covered are long gone. Your doctor will probably affirm this for you.

You think this is bad? Wait until Barak gets his hands all over it.
PepperElf on 08/05/2009:
the purpose of this website is to complain

but there's no guarantee you'll get what you want.
or that your insurance will magically say "yes you can have the more expensive brand for the same price"

if they say no... then you won't get it and you'll most likely have to find a better company.

believe me if this site guaranteed we'd get exactly what we want... then I'd have a free maid, the college would give me a 50% bonus to all of my grades, and I'd have ... heck, I'd take a tactical trunk monkey too. they come in handy when the traffic is bad and some idiot's riding my bumper like it's his new girlfriend.
Anonymous on 08/05/2009:
I am able to get my thyroid medication by brand name because the generics, in this case, are not equal. My doc said that if the brand name is working satisfactorily, she will not change it to a generic. There were studies done that indicated these particular generics are not equal when they were tested (all the thyroid generics). It makes me wonder how many are out there. People are just taking things that are only partially helping their medical condition. That's sad.

misspink, I have Cigna too, but I know the plans differ, probably by employer. They do pay for my brand name RX. Yes, the copay is more, but, like you, it's the price I WANT to pay to maintain my health. Many people I know have had problems with Cigna too (on my plan), but until the employer changes carriers, we are pretty much stuck with it.
Principissa on 08/05/2009:
You can get whatever drug you want, but if your insurance won't pay for it, you will. It's that simple. It sucks yes, but really, unless you are willing to change providers, that's how it is going to be. Quite honestly, I'd get what they give me and be happy I had prescription coverage. There are a lot of folks who aren't as fortunate as you and I and I'm sure that they would be more than happy to have what we do.
PepperElf on 08/05/2009:
or get a job working for a pharmaceutical company

and no I'm not joking.

most of those companies will give you good benefits. and if you buy a medication made specifically by them, you won't be charged.
Anonymous on 08/05/2009:
Princi, I think we talked about this before. Most of the pharmacies now offer the generic drugs for many RX's, pretty inexpensively too. So there are alternatives for people without insurance now too. Thankfully.

As for changing providers, most people can't. You usually have to take what your employer provides you as far as insurance goes. At least that's the way it's always worked for us in private industry.
Principissa on 08/05/2009:
We have. And I think it's a great idea! It's the same at my husband's job as well. You take what they give you or you pay for your own plan out of your own pocket with another company.
Anonymous on 08/05/2009:
I don't think most people would want to pay an outside company. We pay so much in premiums to the employer as it is, I can't imagine what that (other) amount would be.
Principissa on 08/05/2009:
I agree. I've seen what we pay monthly to have the insurance we do through his work and it's insanely expensive. It may be cheaper for one person, but man for four people we are paying a lot.
PepperElf on 08/05/2009:
and there are companies that give you good deals

I don't know what my relatives have but... I know it's not cheap
but even with the expense, all medications - generic or brand name - cost the same ($10) so what they pay in monthly premiums ends up being less than what they'd be paying elsewhere.

so sometimes it pay to shop around for insurance
Anonymous on 08/05/2009:
PepperElf, the good news for us (and I really have to say that), is that we don't have any medical bills and I only have my one RX. We pay more in monthly premiums than we ever get back. But, I guess that's why they call it "insurance"--in case we do need it. No way around it.

I'm in Singapore right now and our coverage is 100% wherever we go here (Cigna International). Luckily, they have great modern medical facilities here. Too bad our insurance isn't as good at home!
PepperElf on 08/05/2009:
actually I don't have anything right now.
I will when I get married - boyfriend is military retiree - but I also know what military medical is like too

get a hard rear-end tap from behind while driving, drive to the nearest military hospital when back pain immediately sets in... only to be told "you're supposed to drive to the one your command's attached to" (over 10 miles away).

Or reach into your car and get a nice laceration from a shard of broken glass. Drive the 10 miles to that hospital, only to be told "we can't treat you after hours - go to your ship or drive 10+ miles to portsmouth"

at the ship - "we cannot treat you, go get some wound-glue" or wahtever it was.

military medical - proud sponsors of a nice half-inch scar on my arm since no one could treat me except a hospital 2 cities over.
Nohandle on 08/05/2009:
All I can say about Generic vs Name Brand is there was a drug I took "as needed" in the past and the Generic did not provide the desired results. I knew immediately and promptly was put back on the Name Brand. I take a drug now that less expensive alternatives are available but my doctor insists his patients who are doing well not change. I do take one Generic drug and it works fine for me.
Anonymous on 08/05/2009:
pepperelf, when someone is retired military, don't they have Tri-Care. I heard that is great insurance. Too bad the Navy couldn't have treated you better:(
Anonymous on 08/05/2009:
Yep, nohandle, sounds just like what my doc told me. I know that some generics work great, but others are just not equal. I think that's good info for anyone to be aware of.
BokiBean on 08/05/2009:
I can believe that. Some generic drugs may work, some may not. But to say that generic drugs don't work for you, across the board, like my sis, is just fiddle faddle.
Anonymous on 08/05/2009:
Boki, I don't blame your sister. I remember seeing the show Eloise mentioned--maybe it was a 20/20. Anyway, it was pretty enlightening. They will hopefully show it again at some point. I didn't want to take generics after seeing--although I do now for the occasional illness.
BokiBean on 08/05/2009:
Truthfully, my sis never saw it either.

She just convinced herself. *grin*
Nohandle on 08/05/2009:
KIA, I have an employee who had thyroid cancer, yep checked into the hospital into that padded room and hospital personnel didn't enter the room without their space suits on. She is quite humorous about the entire experience. She is 100% cured and there are a number of generic drugs available for her ongoing treatment. NO WAY would anyone attempt to change her script to a generic.
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Cigna Fails In Its Promise to provide financial security in the event you become disabled.
Posted by on
I paid group disability premiums for 25 years. I was disabled from working in Jan 2006. Only after writing government officials & filing an insurance dept complaint did Cigna agree to pay. Then after approximately a year of payment Cigna suddenly (without informing me in advance)writes me I am no longer disabled and can return to my regular occupation. This letter came AFTER the check did not show. My physicians support that nothing has changed and I continue to be disabled. This is what Cigna did:

1) They sent my file to two of their doctors for review (of course they wrote "deny" as Cigna pays them to do.

2) They sent the file to their in-house Nurse who wrote "deny" as Cigna pays her to do

3) Put surveillance on me two time which reflected I was not active and info actually supported my case. Sent me to a Functional Capacity Exam which supported I was disabled

4) FINALLY they found a doctor to perform an IME who agreed I was not disabled and was paid $2,000 for a 30 minute exam.

I am appealing the decision but you need to know that Cigna will do everything it can to disclaim benefits you may have paid throughout your career. The federal government really needs to come down on disability companies and enforce major changes to protect the consumer.
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jenjenn on 02/28/2008:
Is this a short term disability plan or long term? If it's a short term, they year is probably the max benefit.
mzmickey on 03/06/2008:
Cigna is impossible to deal with. They just don't care. Thanks for giving me a couple more routes to try.
tumblewic on 03/14/2008:
I am also having problems with Cigna, no one will return calls, emails, or anything. They keep moving my decision date to decide whether I am qualified for long term or not, but until they decide, there is NO income coming in!!
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Terrible Company!
Posted by on
ALTON, NEW HAMPSHIRE -- I'm a former employee of Cigna HealthCare and I wanted to write a review to inform everyone of how horrendous this company actually is. First of all I want to start with Customer service. The employees that take your calls only receive one week of training, ONE WEEK! They are forced to answer the calls as quickly as possible. They are told to say whatever they have to to get you off the phone and take the next call. When they inform you that they will "get back to" its crap. You will never receive a call back. They are not even given the time to research the problem to get an answer for you. Our billing department has about a 30 day backup-meaning you send in your payment and it doesn't post for another 25 days since you mailed it, then you're in danger of being termed for non-pay, chances are it is our fault.

When you are told that we have a "5 business day turn-around" that's also a crock. Have the time that you fax, or send in something, it will be lost. If there is a piece of information missing from the form you send in, someone will shred it so they don't have to follow up with you. Most of the employees will do whatever they can to get out of doing work.

It's truly the most repulsive company out there and I feel really sorry for any of you who carry them as your provider.
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Principissa on 12/20/2007:
When did they fire you?
Anonymous on 12/20/2007:
Isn't this the way most companies operate now? It's all about the money, not the worker or customer anymore. I find it odd that so many companies go out of their way to advertise how they place customers first now. Why do they all say that but do just the opposite? I say let them show us how they treat customers first and stop telling us they do it.

~~JMO~~ That concludes my soap box for today.
Anonymous on 12/20/2007:
lol Principissa. I agree superbowl. Someone please name a health insurance company that isn't a piece of chit, please.
Anonymous on 12/20/2007:
I voted you "best answer" there sheriff!
Anonymous on 12/20/2007:
Thanks Pirate! I voted you "most helpful to consumers everywhere".
jenjenn on 12/21/2007:
I agree with you, but unfortunately, Cigna is not the only culprit!
mzmickey on 03/06/2008:
I can say that this is the kind of treatment I'm getting. Thanks for verifying that I'm not the only one having problems with CIGNA.
Anonymous on 03/06/2008:
At my last job, we found Cigna to be the worst insurance company when it came to quoting a patient's benefits. You could call back three times and get three different answers. We didn't have nearly as much trouble with the other companies when it came to geting correct benefit information.

So, thank you for giving people the "inside" story. It definitely explains a lot--and probably a lot about other miserable companies out there too.
kort on 04/21/2008:
This adds great insight into what I have been dealing with for over 3 months trying to get 1 thing covered. I wish that at my job I could treat people the way their customer service treat me and still have a job. I wish they could be held accountable for how they treat people and handle claims. I would not recommend Cigna to ANYONE! We had AETNA previously and did not ever have trouble like we are now over the same medication coverage.
MarlyB on 01/10/2010:
This is a load of crap, sorry. I work for Cigna and I went through a long MONTH of training. In classroom learning about the entire company and 3 weeks of on the floor training. I don't know what department you worked in, but your story doesn't match up to me.

As far as someone "shredding" the paper work.. correct me if I'm wrong, but our faxes are electronic. There are no paper copy's. So how can one shred something that you never actually touch?

All insurance company's have their flaws, and I am sure of that. But I try my best to help someone out. I've been there before, I've had medical problems and try to put myself in someone elses shoes. I can't speak for every employee here, but I try to find a solution for your problem.

And Kort - as far as coverage is concerned, your employer chooses those options for you. So if something is not covered, we can't go against your plan without written consent from your employer. We can't help if your employer chooses not to pay for something..

nliz_57 on 11/05/2010:
MarlyB- I worked for cigna as well and we did indeed do faxes other than on our computers. I handed my manager several faxes that she did on a FAX MACHINE. Unless you know, you shouldn't be calling anyone a liar. Oh, and there were 17 new hires put on the floor after a week and a half of training. So.... What do you have to say now???
jktshff1 on 11/05/2010:
frustrated customer on 06/02/2011:
I am experiencing this poor customer service right now. Why is it that every other claim I send gets sent into a black hole. They never seem to receive anything I send them, even though I have multiple fax confirmations saying the fax went through successfully. I've even sent the claim directly to a customer service rep who supposedly forwarded it to the claims department, and they still managed to lose it.
True on 05/01/2013:
I've had the misfortune of being a CIGNA customer for about 5 years and this is absolutely consistent with the service I have received. Customer service reps have told me the wrong thing before I sought certain treatments and then CIGNA denied my claims although I did what I was told to do
ConcernedNY on 07/30/2013:
I have to say this has been my experience as well. And for the one who claims they had a full month of training - maybe you should tell us about the part where they TRAIN you to deny everything in the claims area, whether it should be paid or not - postpone, delay, make more work for everyone, then in the end - they have to pay. worst insurance I have EVER had. All may be challenging these days, but I agree CIGNA is the worst!
Mistreated on 11/28/2013:
I work at Cigna and have for many years. I know that some training is less than others. There are also always the suck ups that will take up for the company no matter what. The mistreat their employees. There is so much stress on the employees that it is no wonder that most are on blood pressure meds and anti depressants. They tout quality all the time, but they also want quantity and in my opinion you can't have both. Something as important as a customers account build or claim payment should not be hurried. It causes many mistakes. If you don't meet their quality and quantity standards, they will find another poor sap that needs a job to fill your place. I advise anyone to find work any other place. I have been here so long I have no other job experience and don't feel like I can leave.
MustangSally on 01/08/2014:
I agree with your story, simply because I witnessed some of the same experiences in the eligibility department. It's true that a lot of corporations are in a race to close out as many tickets as quickly as possible, without fully working through the issues. If I had a question about a ticket, on many occasions I was advised to close the issue without fully resolving the issue. If that wasn't bad enough, no one seemed to be accountable in the department or within the entire management structure. Employees with little to no experience in insurance are placed in positions of seniority, while people with many years of experience are placed in unequal positions with small titles and very small pay. It's very common practice for the company to remove large numbers of qualified and experienced employees. When the company realizes their mistake, they reach back out in to the market place and hire new people. The good employees are stuck trying to support all of the new employees, plus make accommodations for management that is inadequate or just sticking around for a pay check. Speaking of a pay check, I probably won't get the last one. Despite multiple efforts to work with management, I have yet to resolve my questions about my final paycheck.
So, you can either hear what I am saying, and decide to dismiss it because you think I was a bad employee who probably left on bad terms, or you can listen to what I have to say and take it as good advice. Trust me. I know what I am saying, when I say this is the worst company I have ever worked for. I don't want to have to explain my credentials or work history. Just take it for what it is, and don't start employment with this company or if you are there seek opportunities outside of the organization and work for a company that knows what they are doing and actually cares about the employees.
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Disability Insurance Illusion
Posted by on
NEW YORK -- In October, 2004, I left my job at a major record company in New York City after seven years, due to the ongoing debilitating symptoms of an autoimmune disorder called Behcet’s Disease. The pain, neuropathy, fatigue, photosensitivity, and cognitive dysfunction caused by this disease proved to be too much for me to continue working at my job as Vice President of the Copyright Department. I am covered for disability benefits through my job by CIGNA Group Insurance. Unfortunately, CIGNA has refused to pay any long term benefits, citing what my wife and I believe are spurious reasons for defaulting on their contractual obligation. Despite medical support from recognized specialists knowledgeable about this rare disease, testimonials from employees at BMG, CIGNA’s initial granting of short term disability benefits for this condition, and my being approved for Social Security benefits following a medical review, CIGNA is maintaining their position even though their doctors have never even seen me.

My wife and I have had to hire legal counsel to request that CIGNA provide documentation under ERISA law and regulations that support their position. We sent a detailed response that included further doctor’s letters and treatment records, however CIGNA replied that they are affirming the previous denial. The cessation of income and mounting legal fees are causing my family severe financial hardship. I paid premiums for benefits that were clearly not available when needed. We do not feel that CIGNA has been full or fair in reviewing this claim, and are denying benefits using stall tactics in an apparent effort to bankrupt and discourage our efforts in securing the benefits to which we are contractually entitled. A quick online search reveals numerous instances in which insurance companies have behaved similarly, often using the exact same boilerplate language to deny claimants of their benefits. In some industries, this type of apparently collusive practice is viewed as anti-trust. We believe that CIGNA's denial was a foredrawn conclusion, and is patently unfair. For the sake of your family, please do not place full confidence in this type of coverage. We did nothing wrong, but learned the hard way.

Policy Details:

CIGNA Group Insurance
P.O. Box 22325
Pittsburgh, PA 15222-0325
Ph. 800 238-2125
Fax. 412 402-3222

Policy Number: NYK 0980002
Underwriting Company: CIGNA Life Insurance Company of New York

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User Replies:
miketech on 02/01/2006:
Sorry that happened to you. I hope you make them pay dearly because that's just wrong. Maybe since its a life long claim they want to test you and make sure you are really sick. If they aggrivate you enough maybe thay figure you will just give up and that would save them a bunch of money. If you picked a good attorney than you should be OK. Best of luck.
CobraCat77 on 02/01/2006:
I'm good friends with a lawyer who specializes in insurance issues. He says that 90% of all claims are automatically denied in the hopes that people will not fight them (and too often, people don't). My opinion? Raise hell till they get so sick of you they give in.
Slimjim on 02/01/2006:
Mike and Cobra are right. Insurance companies have always been reputed as having a denial first policy if they can come up with a reason and will only pay certain valid claims when pushed. Hiring counsel was the right move.
Ponie on 02/02/2006:
Initially, I'm usually suspect of 'disability' claims but this one makes me say GO GET 'EM, TIGER! It's maddening when you pay for a benefit and then are denied when it comes to collecting. Good luck.
abobo on 08/01/2007:
BHS - I hope your lawsuit sees you come out on top. Hopefully you can win a bunch of punative damages to punish Cigna in a meaningful way and prevent them from reflexively denying claims in the future.
ocnoreen on 10/07/2007:
Some comments make me realize how misunderstood this problem is by most people. This is a policy people buy in case of debilitating health problems. Millions or more are sold. I would suggest that given the difficulty of being paid, not too many people get away with fraud on these particular policies. The companies just deny and don't pay. It is a cash cow for insurance companies. I would say that no one should buy any more disability insurance and should ask for it as a paid benefit from their employee. That way, you are not out of pocket for these crooked policies being issued. The government is lax because nobody takes these criminals on in public. We are ill or disabled when we have to do this and they run roughshod over us and we don't have the energy or will to fight them! Hope you get a good attorney to fry them.
kachinkie on 10/18/2007:
I have a similar disease, wegener's granulomatosis, and Cigna gaveme LTD for 2 years but now is refusing me. I have the same symptoms, on the same chemo and steroids, same pain etc that I had 2 years ago, but now I am suddenly not disabled? They never even gave me and IME. I had to seek legal help as well. How did things go for you? Our diseases are hard enough on a daily basis, but then add all of this stress and you have a potential for death. If any other business treated their customers the way insurance companies threat their customers they would be out of business and the government would have their hides. Watch true, sadly
mad at you on 10/27/2007:
I have Cigna disability through my former employer.I have received my disability check
on time every month for nearly five years
no problems.
yayadayle on 02/06/2008:
Thanks for your 3 cents! Here's mine:

I'm now in the "appeal" process with Cigna, having been originally denied. I have Lupus. Fatigue & organ involvement took me out of the career I loved for 20 years.
I provided definitive documentation attesting that I'm not able to work anymore. But I was denied by Cigna. The same week, I was approved for Government SS disability(!!) I thought it'd take me 2-3 years to get SS disability benefits, but I'd have my long paid for, "trusty Cigna" coverage to get me through. Wow, it's turned out to be just the opposite.

So now I'm fighting Cigna... And bottom line, they're squelching on the deal. Obviously, this is not just my problem.

Maybe a class action suit would open their eyes?

Anonymous on 02/06/2008:
yayadayle, sorry to here about your problem but I don't think a class action suit will get any of there attention except the low life laywers that will get all the money in the end. I say keep fighting them on your own and do the lawsuit with your own laywer. Good luck to you and I wish you all the best.
sister3 on 05/12/2008:
I'd really like to know if anyone has had success in these matters? I've read and read about the fights but not the outcomes. Any info would be appreciated!
determined2 on 09/22/2008:
BHS.........I hope that you will read this and respond. I have several questions for you and maybe some information that may assist you.

My E-mail is

Sincerely, determined2
IBeatCIGNA on 10/06/2008:
I was in the same situation as many of you. Initially received benefits for the first year, approved for SSDI. Then CIGNA cut off my benefits with no explanation. I immediately got an attorney, and after going through the rigged appeal process the ERISA law requires, I got a date in Federal Court. The judge rulled in my favor, told them to pay me back pay plus pay me through the 2 year "any occupation" period. They were told to reopen my claim and access it for continuing benefits. They approved it and I have not had a problem since but wonder that at any time they can pull the stunt again. The Erisa law says the employee must pay their own legal fees out of any settlement which is capped at 40%, and can only sue for actual wages. However, I guess the judge spanked them enough that the CIGNA lawfirm actually paid my attorney $40k, more than I would have had to pay him!
CIGNA is evil, they are greed personified, and continue to conduct business in a disreputable manner.
My advise to anyone in this situation: Get a lawyer. Get your records together. Don't allow the CIGNA claim reps to talk to anyone, including doctors, on the phone. Make them write or fax everyone all their questions, and have your doctors send you a copy of every record or questionaire given to CIGNA. When they call you to "interview" you, tell them they must write you with questions, you will not talk to them on the phone. Don't answer the questions until you call you lawyer and fax him/her a copy. In other words, CYA.
determined2 on 10/09/2008:
BHS........My new E-mail is If anyone on this site knows BHS, PLEASE have him E-mail me. I have important information for him concerning his claim.
ddp on 02/11/2009:
CIGNA should be prosecuted for their practices. After fourteen years of long term disability benefits they cut me off. It has been terrible and so stressful. They have done it all. Surveillance, Functional Capacity Evaluation, reports by doctors that have never seen me. Cigna pays these people to say what they want them to say. $700 for a doctor to answer a few questions and report that I am not disabled. They try to beat you down hoping that you will not fight back. But that isn't happening here. I will fight until the end. I can't find an attorney that will help unless I have a large retainer fee. Any ideas?
westwoman on 03/19/2009:
Hey there ddp and ibeatcigna........I, too, have been on Cigna's long term disability through my old employer, A.T. & T, and after 8 yrs. they decided to stop payments! I receive benefits under SSA, but "they" said no! I have Rheumatoid Arthritis and it doesn't get better...only worse, so I've appealled and still they deny claim. I've found a law firm on line, but haven't gotten any further...any suggestions???????? This is so stressful and upsetting........!!!!
IBeatCIGNA on 10/13/2009:
to westwoman: find a lawyer by asking friends, and looking for a lawyer who works ERISA claims. They should take you on a contingency basis. Also, it is very important to continue to see your doctor, and make sure your doctor documents your appts and NEVER talks to the insurance company on the phone. only by letter. and get a copy of all correspondence between CIGNA and your doctors. So you know what is being said about your condition. You doctor needs to be your advocate. And you needs to document everything.
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