CIGNA

Hello-Thank you for forwarding this claim to CignaWe we review this complaint and folldirectly with the customer.Tanya H***CignaExecutive Office of Complaints

Worst insurance ever! They deny everything and try to find loopholes out of paying! Took months of fighting to get them to pay my son's dentist billEvery excuse in the book! Finally the office was about to send me to collection, I had to threaten a lawyer to get this resolvedThen, they stopped paying my husband's bills and claimed it was because he had a second insuranceNo, he's only had cigna for the last yearsNothing had changedThey will try ANYTHING and EVERY EXCUSE to get out of paying bills

Good Afternoon,
Thank you for this information
I have sent complaint resolution correspondence to the customer on February 26,
Thank you,
Rae B***

October 8, 2015Dear Sir or Madam:We are writing in response to your correspondence dated October 1, 2015, referencing *** *** ***’s claim for Long Term Disability (LTD) benefits*** *** was covered under her employer full- insured LTD group benefit policy ***This policy was
underwritten by *** *** *** ** *** *** (***) and sitused in the state of Massachusetts.*** *** raised concerns regarding ***’s adverse decision on her LTD claimPlease allow us this opportunity to address her concerns, explain our decision, and provide a current update.With respect to *** ***’s employer’s LTD policy ***, in order for benefits to be payable, her medical records needed to support that her health conditions caused a functional impairment that would continuously prohibit her from performing the material duties of any occupation beyond months of benefitsThe policy’s “Definition of Disability/Disabled” lays out these requirements and is defined on page of the enclosed policy.While her LTD benefits were approved for a time, continued LTD benefits were not payable to *** *** beyond June 16, 2015, because she no longer met the policy’s definition of DisabilityThis determination was based on our ongoing medical review of the relatively stable findings and low treatment intensity received from her providersAfter a complete medical review of the available records on file, it was determined that *** ***’s condition would not render her Disabled beyond the date referenced above, according to the terms of her LTD policyAs a result, no further benefits were payable and her claim was closedOn June 16, 2015, a letter was sent to *** ***, which explained our decision and provided information that may be helpful to perfect her claim.We understand that *** *** disagrees with our decision of her LTD claimAccording to our review, she has since filed an administrative appeal with our companyAt this time, her claim has been assigned to Appeal Specialist, Linda G., for reexaminationWe are fully committed to conducting full and fair reviews of all claims, and will consider any new information *** *** wishes to submitOnce all of the information she wants to provide has been collected and an appeal decision has been rendered, Linda will contact *** *** directly with the outcomeIn the meantime, should she have any specific questions regarding the appeal process, *** *** can always contact Linda directly at ###-###-#### for further assistance.Thank you for allowing us this opportunity to respond to your inquiry regarding *** ***’s LTD claimWe hope the information provided is helpfulShould you have questions or would like to discuss this matter, please do not hesitate 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,Rick PConsumer Advocacy Specialist

Hello,Thank you for this information.I will be in addtional review of this issue and will respond directly to the customer.Thank you,Nicole P***

We are writing to respond to your correspondence dated April 21, 2016, regarding Joey ***’s claim for Long Term Disability (LTD) benefitsMr*** was covered under his employer provided, fully-insured LTD policy ** ***, which was underwritten by *** *** *** ** *** *** (***) and issued in GeorgiaMr*** raised concerns regarding Cigna holding out doctor’s reports in our reviewsAs we have previously explained directly to Mr***, during an external medical review records were accidentally left out of those submitted to an independent peer reviewerOnce this was brought to our attention, the records were then forwarded and we sought an addendum from this peer reviewerWe are confident that all of the records have now been considered and that a full and fair evaluation has been completedMr*** also indicated that we asked a specialist if we felt he was physically disabled, which is inaccurateWhat Mr*** is referring to is a peer review report in which a peer reviewer indicated that he found evidence to support restrictions supporting his health condition dating forward from June We followed up with this reviewer and asked that they provide the earliest date these restrictions would have supported, at which point he confirmed only going forward from June To qualify for benefits, Mr*** needed to be deemed continuously disabled from October 29, forwardSince he was not, we upheld our previous decision to deny him further benefits.Should you have any questions or would like to discuss this matter further, please feel free to contact me directly at ###-###-####Sincerely,
Eric F*

I have been in contact with the customer and all his concerns have been addressed.Pamela D***

[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:
Long Term Disability is something that we as employees pay into in case situations such as mine's occurs.
Secondly, there have been other employees in similar situations, and have received their STD and LTD
Thirdly, I received information from Cigna, explaining to me when my employment disability will begin and the amount (please see attachment) and the company have now went backwards on their own words and policy.
According to the information that this company has rendered, they were willing to start the benefits, but was informed by my employer (***r) not to do so; this in itself is contrary , uncharacteristic, and even subordinate for prejudicial treatmentFourthly, since this company (Cigna) has clearly stated that *** is the primary reasons for Cigna's inaction concerning my STD and LTD: I feel that it is only fair to also file a claim with the Revdex.com against *** for the twin reasons or the matching of correspondence of this complaint current complaint. In the forthcoming complaint, I ask that the information rendered by Cigna in this grievance should not be closed for the necessity and pertinent impending. To close the gap in resolving the current issue, I believe that in the corrective stage and only in such stage of the forthcoming complaint should this current complaint be withdrawn, freely by me
Lastly, after speaking with MrP*** on Wednesday July 1, 2015, the response was yet unclear and conflicting in regards to STD and LTD. Thereafter, I informed him that I have sought an attorneyMrP*** stated that the Revdex.com would contact my attorneyHowever, the Revdex.com does not have my attorney's name or number so I do not know the nature of his remarkNevertheless, I am enclosing the information here: *** and *** ###-###-####
Regards,
*** ***

Hello-
A resolution letter was mailed to the custoner on July 30, If the customer wishes for the results of the review to be shared with the Revdex.com, the ***ached Authorization form will need to be completed and returned to Cigna
Thank you
Tanya H***
Executive Office Advocacy Team

A response letter and payment were sent on 11-06-
thank you

Hello,
Thank you for this information
A written response with resolution is being sent to the customer today 08/03/
Thank you,
Nicole P***

Hello,
This complaint has ben received by Cigna's Executive Office of ComplaintWe will follow up with the customer for resolution
Thank You,
Rafael P***

---------- Forwarded message ----------From: M***, Erica * *** Date: Tue, Apr 25, at 9:AMSubject: *** *** *** ***.To: Revdex.com Thank you for forwarding this complaint to CignaCigna has reviewed this complaint and resolution letter has been sent to the customer on April 20, Per the member’s request, Cigna has mailed the member detailed information regarding dental servicesMember’s concerns has been properly addressed by Cigna Customer Advocates and the Executive Office of Complaints Best Regards, Erica *M***Executive Office Advocacy TeamPhone: *** Email: ***@cigna.com

Hello,Thank you for this information.I will be in review of this issue and will respond directly to the customer.Thank you,Nicole P***

Thank you for the additional informationI have reached out directly to the customer to address the issueThank you,
Nicole 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 Administratively Resolved]
Complaint: ***
I am rejecting this response because:Cigna responded by letter stating, I was never covered due to a dual policy Cigna told me I could take out an individual policy because of my maxed out primary insuranceCigna accepted five payments and rejected all of my claimsThis is utterly ridiculousI would not have went to the dentist if cigna would not have enrolled me in an individual planI had to pay a lump sum to my dentistCigna is a very unprofessional company that does not pay attention to detailThis is the most horrible customer service, to make a customer pay for a business's mistake
Regards,
*** *** ***

Hello-Thank you for frorwarding this customers complaintWe will review and folldirectly with the customerTanya H***Cigna's Executive Office Of Complaints

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending
it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** *** Cigna did call me today, I was not home I returned the call, the extension I was told to call, was for another person I did leave a message I will attempt to call again tomorrowThank you for your prompt responses*** ***

Thank you for forwarding this customer's complaintCinga will review this and follwith the customer directly
Thank you