CIGNA

October 30, 2015Dear *** ***,We are writing in response to your follinquiry regarding *** ***’s Short Term Disability (STD) claim*** *** raised additional concerns regarding the overpayment on her STD claim, and that she felt pressured to make payment arrangementsWe have further reviewed *** ***’s situation and the concerns she has raised, and have waived the overpayment on her claimWe will notify *** *** directly, and that trust this will resolve this matter to her satisfactionShould you have any questions or would like to discuss this matter further, please feel free to contact me directly at ###-###-####You may also contact CGI’s Consumer Advocacy department regarding any group disability, life or accident concerns at:Cigna Consumer Advocacy Attn: Meredith ** L*** *** *** *** *** Phoenix, AZ *** Email: [email protected] Fax: ###-###-####Sincerely,Brenda WManager, CGI Consumer Advocacy

Hello-
Thank you for sharing this customer's responseCigna will contine to review and folldirectly with the customer with additional information
Tanya H***
Cigna Executive Office of Complaints

Cigna is reviewing this matter and will respond with additional information. We take patient confidentiality seriouslyProtecting our customers’ personal health information is criticalSo much so, that the Health Insurance Portability and Accountability Act (HIPAA) requires that we
protect an individual’s private health information (PHI)Because this matter requires that we look into personal information, we need him to give us permission to share our findings with the Revdex.comMatthew Rosefsky can grant this permission by signing the attached Authorization for Use and Disclosure form. Alicia G***Executive Office Advocacy Team

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because:My first doctor's appointment was on February When I filed this claim I asked what paperwork needed to be filled out and was informed by Matthew Hayward that I would receive a package in the mail in about to days with paperworkWhen that paperwork came there was nothing in it that needed to be filled out by myself or the doctor...it was only paperwork showing how much time I had available to use for the medical leaveI called back and was told that Cigna would be contacting the doctor to get the information they neededWeeks passed by and I still never heard anythingAfter leaving several messages and even going to my human resources manager at my job I finally got the paperwork to take to the doctorSo I was told Cigna was contacting the doctor...but then I get the paperwork to take to the doctorSo it is like I was just getting the run around when that paperwork should have been sent to me in the package or they should have sent it to the doctor like they said they wouldWhen I went to the doctor on April I called Kate that same day and once again left a message because she did not answerI told her that the doctor had me out of work for another weeks and asked what paperwork did she need so that there was not another delay in my paymentsI left a message everyday that week...and finally talked to someone who told me that I needed to send in the doctor visit notesI was told this on Friday...April So I went to the doctor on the and could have had them fax the office visit notes to Cigna that same day if Kate would have returned my call and told me that's what needed to be done I was told by one of the representatives at Cigna that the request for the paperwork was not even asked for until April So it took days for Kate to even ask the doctor for the paperworkI finally called Cigna and asked to speak with a supervisor or someone above Kate because I was fed up with leaving message after message and never getting a response I left a message stating my frustration with Kate and the fact that it had taken over weeks for me to get a payment and that she was not responding to any of my messages I never received a response from this person either I finally got a call on April from Cigna saying they had received this complaint and that a check was released that dayThe last check I got was mailed out on a Tuesday and I received it on Saturday So now this check was sent out on Monday...and it's Monday of the following week and I still have not received the check So I feel the only reason Cigna finally responded was because I filed this complaint There was no concern about returning my calls...getting me paperwork in a timely manner or the fact that it is now May and im still waiting on payments I want to be compensated for the stress...late fees and past due bills I have encountered because of their lack of concern and the way they have handled my disability claim
Regards,
Rolanda Blackman

Hello-
This complaint has been addressed directly with the customerThank you
Tanya H***

Hello-Thank you for forwarding this customer's complaintCigna will review and folldirectly with the customer.Thank you.Tanya H***

Thank you for the information. Outreach will be made to the customer to go over this account. Thank you
Kelly M***

Thank you for this informationI will be in review of this issue and will respond to the customerThank you,
Nicole P***

Thank you for forwarding this complaint to CignaAn outreach attempt to contact the customer has been placed, A Voicemail message was left advising the customer their concerns are being reviewed and to contact me with any additional questions or concerns. Pamela D***
*** ***
*** ***

A written response has been sent to the customer in regard to Revdex.com complaint # *** as of today

Hello-Cigna is reviewing this customer's complaint and will folldirectly with the customerIf the customer wishes to have the complaint resolution shared with the Revdex.com (Revdex.com) the ***ached Authorization for Disclosure of Protected Health Information form needs to be filled out
and returned to Cigna Thank youTanya H***Cigna Executive Office of Complaints

Thank you for forwarding this complaint to CignaCigna has reviewed this complaint and resolution letter has been mailed to the customer on 11/01/2016.Charlene V***Executive Office Advocacy Team

Hello,
Thank youCigna has received this complaint and will follow up with the member directly for resolution
Regards,
Rafael P***

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed as Answered]
Complaint: ***
I am rejecting this response because:
Regards,
*** ***
Yeah that makes perfect sense and would have been an acceptable response DAYS EARLIERWhy was I knowingly lied to for a week over several blood curdling phone conversations? The moment the pre-approval was received by your company you knew full well it would be denied because of the secret standards that you deliberately communicated to no one, yet your representatives shamelessly and self righteously lied to me that the approval was underway and I would be able to schedule in the coming week. The most hilarious part is, the morning of the scan after you had told my doctor that it was approved I called in just to check (because now I know your organization runs on lies and human misery) and was told that it was not approvedleading to another blood curdling hour long phone call to discover that you had lied to my doctor again and not done your jobHad I believed you and done what you told me to do I have every reason to believe that you would have attempted to screw me AGAIN. This is a systematic pattern of behavior of revolting antagonism towards your customers, hideous dishonesty and deliberate deceitIf this is consistent with the Revdex.com's idea of better business, I'm shocked

Claimant’s
Name: *** *** Policy
Number: VDT *** Policy
Holder: Lake County Board of County Commissioners NAIC
Number: *** CGI
Incident Number: *** CGI
Matter Number: *** Underwriting
Company: Life Insurance Company of North America
Dear
Ms***,We
are writing in response to your March 28, inquiry regarding Mr
*** ***’s Short Term Disability (STD) claimMr***
is covered under his employer’s STD Policy VDT ***, which was
underwritten by Life Insurance Company of North America (LINA) and
issued in the state of Florida.We
understand that Mr*** is concerned with the time it has taken
to complete the review of his STD claimMr***’s claim was
received on March 14, On March 22, 2016, our claim manager
discussed the details of his claim with him, and we obtained the
verbal authorization necessary to request medical records from his
providerRecords needed for our review were then requested from Dr
Austin.Upon
receipt of Mr***’s complaint to the Revdex.com,
our STD claim team was contacted to verify if all information had
been received and a decision could be reachedOur STD claim team
confirmed that information was still needed from DrAustinAs of
April 1, 2016, a response has been obtained and Mr***’s
claim is currently being reviewed by our STD Claim teamMr***
will be promptly notified of the outcome of our review, once a
decision has been reachedIf additional medical information is
required from his providers, he will also be notified of this factAs
Mr*** was advised in our March 21, letter, if we do not
receive the requested information necessary for this review by May
10, 2016, it may result in an extension of the time period required
to make a decision, or our decision may be based on the available
information on fileShould you have any questions or would like to
discuss this matter further, please feel free to contact me directly
at (412) 505-Sincerely,Eric
F*,Compliance
SpecialistCGI
Consumer Advocacy

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because:I did not see this requirement on the web pagesThis requirement was not on the Cigna form which was requiredApparently this requirement was not discoverable to the several customer service representatives who promised it would be taken care of for
Regards,
*** ***

Cigna is reviewing this matter and will respond with additional information We take patient confidentiality seriouslyProtecting our customers’ personal health information is criticalSo much so, that the Health Insurance Portability and Accountability Act (HIPAA) requires that we protect an
individual’s private health information (PHI)Because this matter requires that we look into personal information, we need her to give us permission to share our findings with the Revdex.comLaura Ettleson can grant this permission by signing the attached Authorization for Use and Disclosure form. Charlene V***Executive Office Advocacy Team

Thank you for forwarding this rejection to CignaA letter detailing the plan benefits and the customer’s out-of-pocket accumulation was mailed to the customer on 10/25/2016. After review, it has been determined that the out-of-pocket has not been over applied.The Executive Office of Cigna has sent a resolution letter to the customer on 10/27/2016.Charlene V***Executive Office Advocacy Team

Hello-
This issue has been resolved and we have spoken to the customer directly to advise on the resolutionThank youTanya H***

Thank you for forwarding this complaint to CignaCigna has reviewed this complaint and resolved issue with customer on 10/05/2016. Erica M***Executive Office Advocacy Team