WILMINGTON, NORTH CAROLINA -- Our actual was on the phone with Cigna's precertification process for a ** pain medication that had been turned down at the pharmacy. He gave them the code for metastatic stage 4 brain cancer and then asked what the issue was - that was all the information they should need to certify the drug. After 45 minutes of speaking back and forth, Cigna failed to give my wife pain medication for STAGE 4 BRAIN CANCER. UNBELIEVABLE! If anyone is interested in joining a class action against Cigna, please let your voice be heard. Cigna is playing like they are the doctor and this is unacceptable. They are an administrative tool to process payments. Period.
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.
Cigna is absolute garbage insurance. They deny and delay necessary procedures and treat their members terribly.
In short, I have a torn spinal disc on which I was supposed to have surgery about 2 months ago. Cigna denied my surgery, and my experience since then with Cigna in trying to resolve this has been utterly awful.
Cigna decided that my surgery was not medically necessary because I hadn't seen a psychiatrist, which is absurd. 2 MRI's and other diagnostic procedures clearly indicate a torn L5-S1 disc as the source of pain. The issue with my spine is quite obviously mechanical, and so the requirement to see a psychiatrist was a complete waste of my time and money, and kept me in pain needlessly. But I went ahead and saw the psychiatrist anyway, figuring it was the fastest way to get approval.
After Cigna lost the records my doctor sent over multiple times, I was finally able to get them to confirm they had what they needed. At this time, I was told they would reach a decision in 5 business days. After a week, I called to find my case was not even under review. Then, I was given a new promise of a decision within 72 hours. After that time elapsed, I was told that no decision had been made and they couldn't even tell me why. After several more calls and more conflicting answers, I'm now being told that I'll have to wait 30 days. No one at Cigna seems to have any clue what is going on with my case, and they just give me false or conflicting information.
Cigna "Customer Service" is a complete nightmare. They have given me false information over and over, and refuse to take any responsibility for it. I satisfied their requirements for this surgery over a month ago, and yet they continue to delay. They seem content to keep me in pain indefinitely, with an ever-changing story about when I'll get a resolution. Cigna simply does not care about their members at all, and they operate in bad faith using questionable denials and delays.
MISSISSIPPI -- CIGNA sucks. I was put in the hospital from my regular physician due to excessive vomiting and nausea. After being in the hospital for a couple of days, my test results showed I had a hernia that was ulcerated and my liver was enlarged to the excessive side. (Example: normal liver enzymes should be 7-56, mine was 675!!!) I was seen by a gastro doctor who also said I had gastroparesis. (This is due to being a diabetic for over 30 years. The nerves in my stomach did not work anymore and did not push food through my body.) Because I had been on STD before, I knew I needed to have paperwork completed and sent to CIGNA.
The gastro doctor saw me in his office and signed my paperwork to be out due to the conditions from being in the hospital. However CIGNA stopped paying my STD after a week and a half. When I called and spoke to my case manager, if that's what you would call them, because I am also a case manager, he simply told me they were waiting on paperwork. I told him I have paperwork if he would like me to send and he said it could. It wasn't until a month later. Yes a month later that he stated to me after several calls that the paperwork I sent him was just a summary. WHAT??? it was their paperwork.
To make a long story short, I ended up being denied my STD even though I have paperwork from 2 doctors putting me out of work and stating that I could not return to work. I am totally disgusted with this company. They did everything they could to contradict what the doctors were telling me to do and lied to me regarding PAPERWORK they said they never received. Our health system has gone out the window and this company from what I understand has been in several class action lawsuits. Maybe it's time they were in another one.
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.
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?
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.
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????