(Compiled by Northeast Action.)

• 2008 revenues: $17.6 Billion

• Customers: 11 million Americans

• Spending on Federal Lobbyists Since January 2008: $3.2 million

Former CIGNA Vice President Reported on Company’s “Purging” of Undesirable Customers. In 2009, Wendell Potter, formerly Vice President of Corporate Communications for CIGNA, “described how underwriters at his former company would drive small businesses with expensive insurance claims to dump their Cigna policies. Industry executives refer to the practice as ‘purging,’ Potter said. ‘When that business comes up for renewal, the underwriters jack the rates up so much, the employer has no choice but to drop insurance,’ Potter had said.” [CNN, 8/18/09]

In 2009, AMA Sued CIGNA, Accusing Them of Underpaying Doctors and Forcing Patients To Pay Excessive Costs for More Than a Decade. In February 2009, the American Medical Association and the medical associations of several states filed a lawsuit against CIGNA and Aetna, accusing the two insurers of “duping several constituents out of deserved funds using ‘rigged data’ from their Ingenix database.” The suit accused the companies of “underpaying physicians” and forcing patients to pay “excessive costs for more than a decade using the Ingenix system for out-of-network claims.” [Forbes, 2/10/09]

CIGNA and Its Subcontractor Paid $27 Million to Settle Accusations Inflated Rx Drug Costs and Pocketed Rebates. In 2008, the Hartford Courant reported, “Express Scripts Inc. and CIGNA are paying a total of $27 million to settle a 2004 lawsuit by the state of New York that accused Express Scripts of getting doctors to switch patients’ drugs and pocketing rebates from drug companies. The allegations involved prescription benefits for New York’s Empire Plan, which covered more than 1 million active and retired state and local government employees and dependents at the time. The suit also said Express Scripts inflated the cost of generic drugs for the plan. CIGNA is involved in the settlement announced Tuesday because it insured the state’s prescription drug plan and subcontracted Express Scripts to manage the drug plan benefits.” [Hartford Courant, 7/30/08]

CIGNA Fined More Than $2 Million for Allegedly Steering Small Businesses to Plans With Less Benefits. In 2007, the New Jersey “ordered Cigna HealthCare of New Jersey and an affiliate to restore a higher level of coverage to 2,123 small businesses and fined them over $2.1 million. Cigna and the affiliate, Connecticut General Life Insurance Co., failed to properly notify the businesses of their health plan options and steered them to plans with ‘substantially reduced benefits,’ the state Department of Banking and Insurance charged….The department said Cigna HealthCare applied in March 2006 to withdraw 35 benefits from its standard HMO plans for small employers. The withdrawal was allowed, but Cigna failed to notify the employers, as promised, that it would still be offering the state-mandated HMO plan, according to the commissioner’s order. Instead, Cigna urged employers to enroll in a Connecticut General plan, and failed to explain that the ‘exciting new options’ had a significant reduction in benefits, the order said.” [AP, 5/1/07]

CIGNA Claim Denial 2^nd Highest in CA Study. Using data culled from California’s Department of Managed Care’s Web site, the CNA said it found that the state’s five largest insurers rejected 31.2 million claims for care from 2002 through June of this year. According to the nurses’ union, PacificCare denied the largest percentage of claims (40 percent), followed by Cigna (33 percent), HealthNet (30 percent) and Kaiser (29 percent).
http://www.sdnn.com/sandiego/2009-09-14/news/why-insurance-companies-are-denying-health-care

CIGNA Patient Stories : CIGNA

­­­­­­­­­­­­­­­­­­­­Teenager Died After CIGNA Denied a Liver Transplant; Company Defended Its Decision.

In 2007, a California family accused Cigna of “maliciously” killing their 17-year-old daughter, Nataline Sarkisyan who died a few hours after the company approved a procedure it had previously described as “too experimental.” After the girl died, the company “stood by its initial decision.” CIGNA executive David Cordani said that, just before she died, the company authorized the transplant even though it still considered it experimental, and therefore outside the scope of her coverage. “Cigna did not reverse the clinical determination that the member’s plan did not cover the transplant,” Cordani said. “In fact, Cigna went above and beyond the plan and offered to provide payment in the event the procedure should be completed.”

Hilda and Krikor Sarkisyan went to CIGNA’s Philadelphia headquarters, along with supporters from the California Nurses Association, to confront CEO Edward Hanway over the death of her 17-year-old child.  “CIGNA killed my daughter,” Nataline’s mother Hilda told security. “I want an apology.” Sarkisyan was not able to speak to Hanway; a communications specialist talked to her instead. After their conversation, employees heckled the group from a balcony; one man gave them the finger. CIGNA called the police and had the family and their friends escorted from the building.

[ABC News, 12/21/07; Los Angeles Times, 12/25/07]

http://www.huffingtonpost.com/2009/10/08/cigna-employee-flips-off_n_314189.html

CIGNA hides cancer diagnosis for over a year

Jo Joshua Godfrey had cancer without knowing it for over a year. I would go to the CIGNA health clinic and they would tell me I had bronchitis and give me medicine and send me home. No matter what medicine they gave me I wouldn’t get better. Then the CIGNA Director called me up and she told me that there was nothing wrong with me at all. I called another doctor (outside the CIGNA system), and I came with my film and my CAT scan and he just put it in, it took exactly thirty seconds. He told me, ‘You have cancer,’ and he said the reason CIGNA did not want to give you your records is they’ve known right way back for years that you have cancer and they’re not going to treat you.”

Jo Godfrey, a lung cancer survivor and CIGNA policyholder, told the gathered SEIU members about how her doctor refused to diagnose her lung cancer at CIGNA’s behest. At the end of her story, Jo said she thinks a strong public option is the best solution to our current, broken system: “I really believe that having an option to get a plan that’s not controlled by the insurance companies, that doesn’t make a profit, is the fair thing to do, and it will save lives.”

http://www.seiu.org/2009/09/seiu-local-775nw-bring-reform-to-cignas-front-yard.php

Mother of young children denied needed therapy

Stephen Coddington’s wife Marian, suffered a major stroke .  The case manager at the nursing home called me in and was really upset, and she said, “CIGNA is wanting to discontinue therapy with her. The doctors called and appeals were denied.” It has been a day-in and day-out fight. Every talk that I’ve had with them, it’s been, how can we wiggle off this hook.

http://crooksandliars.com/dday/cigna-denies-cancer-patient-care-ceo-makes-12

http://savestevesfamily.blogspot.com/

CIGNA refuses needed treatment for 4 year old twins - drives family to bankruptcy

Stacie Ritter is a hardworking mother of twins who lives in Pennsylvania.  Her daughters, now 11, were diagnosed with leukemia when they were four. They both needed stem cell transplants and other cancer treatments. The twins survived, but the glands controlling their growth were damaged beyond repair from the treatment. To continue growing, they needed doctor-recommended growth-hormone injections regularly.

Stacie’s husband’s company switched to CIGNA health insurance, and CIGNA refused to cover the hormone shots. Each time Stacie takes her daughters to the doctor for the shots, it costs her $440. Between the cancer treatment and the denied care, Stacie and her husband had to file for bankruptcy.

Dawn Smith denied care by CIGNA until they are in the  spotlight

In 2005, Dawn Smith was diagnosed with a brain tumor-then in 2007, a second one. After a battery of tests, three doctors from three leading health care systems in the metro Atlanta area agreed that her only chance for a cure was to see a specialist at Cleveland Clinic or Washington University’s Center for Advanced Medicine. Yet for two whole years, CIGNA has refused me the care she need. Then, CIGNA’s pharmacy called to say that the co-pay on the medicine that helps control her debilitating head pain is skyrocketing from $10 to $1,115.

Now that the spotlight’s on them, they’re changing their tune. CIGNA said they would pay for a test Dawn has been asking for the Cleveland Clinic. It was a step in the right direction. But after two years of denials, and with a long course of treatment ahead of me, we  knew better than to just take them at their word. Unfortunately, they didn’t offer any explanation for all the previous denials or a guarantee that they’ll approve the next step in Dawn’s treatment.

­­­­­­­­­­­­­­­­­­­­­Annette Noe denied care by CIGNA until they are in the spotlight

Doug Noe’s daughter 3 year-old daughter Annette had been born deaf and needed a pair of high-tech devices known as cochlear implants, one for each ear, to hear and develop normal speech. But days before the scheduled surgery, CIGNA, to whom Noe had been paying $600 monthly premiums, okayed just one implant-deeming the second “experimental.”

Noe, 60, decided to e-mail Moore Moore and tell him his story. He also fired off a letter to CIGNA: “The noted filmmaker Michael Moore is gathering health-care horror stories. Has your CEO ever been in a film before?”

The day before a conference call last May to argue his case, Noe got a voice mail from CIGNA saying the company had “redecided” his appeal. While not commenting on the specifics, CIGNA’s Dr. Jeffrey Kang says that, at that time, it was their policy not to cover two implants because of a risk for bacterial meningitis. But Annette Noe is making great progress with the two implants she received. “How can anybody deny treatment for a child with disabilities?” asks her father. “In this country?”

http://www.people.com/people/archive/article/0,,20061418,00.html

CIGNA doctors miss cancer diagnosis for 2 years

For two years the CIGNA doctors could not find out what was wrong with Virgie Spense’s  husband, Bill. Worried about her husband’s failing health she went out of network to The Simpson Medical Clinic in Santa Barbara in 1993. The first night at the hospital the ENT specialist gave the couple a preliminary diagnosis that was confirmed within three days by a biopsy. Those three days saved his life. He sadly passed away in 2009 from a repeat of the same disease but he had 15 years of relative good health in between.  At first CIGNA tried to not pay for Spence’s out-of-network bills, but after countless meetings the bills were paid. Once Spence was in remission the couple obtained a different carrier for their future medical needs.

www.UnitedPatientsOfAmerica.org

CIGNA insurance company rules leads to complications and return to hospital

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­

Ruby Calad, from Houston, underwent surgery for a hysterectomy. She was insured by CIGNA HealthCare of Texas, Inc. through her husbands employer. CIGNA would pay for only one days stay in the hospital, even though Calads physician recommended longer care. Calad suffered complications, forcing her to return to the emergency room a few days after being released.

http://onthedocket.org/cases/2003/aetna-health-inc-et-al-v-davila-juan-cigna-healthcare-texas-inc-v-calad-ruby-et-al-062120

CIGNA has not sent disability for lung cancer

ReginaAtchinson has You were reading a complaint about CIGNA.

Filing a new complaint about

small cell lung cancer and can not work. CIGNA has not even responded to her disability claim yet and she haven’t received a single payment. As she posted on a blog  — ” I have had  to cancel two doctor appointments because I don’t have the money to pay for them. It is now February 18th and I have an appointment with my Oncologist on March 6th. If I don’t receive a payment by then I’ll have to cancel that appointment also. I am supposed to get another CT scan on the 6th to see if my tumor has shrunk yet. I also have brain radiation appointments that I can not keep. Each doctor’s appointment cost me $30 (co-pay) but, without my disability, I can not go to the doctors. What is going on here? I can’t even get CIGNA to return my calls. ”

http://cigna.pissedconsumer.com/cigna-has-not-sent-disability-for-lung-cancer-20080217113278.html

Mother wins suit with CIGNA to get daughter needed care.

Suzanne Bynum’s daughter Katrina was born with a severely twisted neck and an abnormally asymmetrical head.  Ms. Bynum’s doctors recommended the DOC procedure - to ensure the condition did not lead to further deformities or physical impairments of the facial region, such as malocclusion of the mandible. “The procedure cost a total of $3,000.  Katrina’s Claim was filed with CIGNA on May 16, 2000, and the next day one of CIGNA’s Medical Directors wrote Ms. Bynum a denial letter, advising, after “careful review,” that CIGNA had “determined that coverage is not available … because cosmetic services are not covered.” CIGNA’s denial letter offered no explanation of what constituted a cosmetic service, and the Plan contains no definition for either the terms “cosmetic” or “cosmetic services.”  With the lawsuit, CIGNA was forced to cover this treatment.

http://openjurist.org/287/f3d/305/bynum-v-cigna-healthcare-of-north-carolina-incorporated

CIGNA Asks - Is Chemo Medically Necessary?

This is actually the second time I have been with CIGNA, not by choice, it was chosen by the company I work for. The first time I was with CIGNA my oldest child was diagnosed with cancer, they actually sent me a form to fill out and ask if Chemo was medically necessary, what a joke of an insurance company. Hopefully our company will change carriers since there have been so many issues with CIGNA.

Posted By: Upset with Cigna on 10/1/2009

http://www.my3cents.com/showReview.cgi?id=63726

CIGNA requires end stage renal failure patient to halt life-saving medicine

By means of a back story, I have had type I diabetes for 48+ years with end stage renal failure (ESRF). Because of this I also suffer from severe anemia. Two years prior to my husband’s company switching to Cigna my anemia was managed successfully by a drug called Procrit. Once my insurance was switched to Cigna, the authorization for Procrit was DENIED based upon the fact that my “numbers” were within normal range.

This, as you might imagine, was due to the fact that I was on the Procrit. Cigna has now required me to go off the Procrit (thus experiencing severe anemic consequences)so as to prove I need the Procrit. In addition, they will NOT provide either me or my MD with the level that would qualify me for this drug! I am not not only frustrated but physically sick due to Cigna’s mismanagement of their program!

Posted By: jye on 7/9/2009

Fed up with CIGNA Exclusions and Catch -22’s

Since switching to Cigna since the start of the year, I have been beyond stressed, frazzled and amazed at how horrible coverage is. There are ‘exclusion clauses’, the fine print of insurance companies, everywhere, which have excluded us from services several times so far. And it’s only March. One example: They won’t cover speech therapy for my 4 year old son unless he has an official diagnosis of autism. But, they won’t cover ANY of the doctors/clinicians that can give that diagnosis. (And there are several different kinds of practitioners who can do this). I’m quite sure this was by design. I am disgusted beyond belief.

osted By: asdmom on 3/14/2008

Sources of Cigna stories

§  http://www.guaranteedhealthcare.org

§  http://www.pissedconsumer.com/

§  http://crooksandliars.com/

§  http://openjurist.org

§  http://www.my3cents.com

§  www.fiercehealthcare.com