Cigna Improper Medical Claim Denial – Class Action Investigation

Do you believe that Cigna wrongfully denied your medical claim for tests and procedures commonly prescribed for an ailment?

 Chimicles Schwartz Kriner & Donaldson-Smith LLP is investigating a potential class action related to Cigna’s claim process that allegedly improperly denies payment for necessary medical treatment.

According to reports, Cigna’s claims review system has a set of tests and procedures approved for corresponding ailments.  The review system then utilizes an algorithm that identifies mismatches between diagnoses and what Cigna deems to be acceptable tests and procedures for those ailments.  The tests and treatments typically cost a few hundred dollars each.  These claims are then denied as not “medically necessary” following, what is alleged to be, a batch cursory review that does not result in a fair and meaningful review of each claim. Insureds have identified such denials for treatments and procedures related to:

  •  Diagnostic nasal/sinus, functional endoscopic sinus and turbinectomy procedures
  • Vitamin D Testing
  • Continuous Passive Motion (CPM) Devices (including as part of a knee replacement)
  • Use of Airway Clearance Devices in the Ambulatory Setting
  • Coverage of Pressure Reducing Services (including powered pressure-reducing air mattresses)
  • Septoplasty
  • Peripheral Nerve Ablation for Pain Conditions
  • Ambulatory EEG (Electroencephalography)
  • Strapping
  • Elastic therapeutic tape/taping (Kinesio™ tape, KT TAPE/KT TAPE PRO™, Spidertech™ tape)
  • Scrotal Ultrasound
  • Peripheral Nerve Destruction for Pain Conditions
  • Endometrial Ablation

If, while insured by Cigna, you had a medical claim denied for tests or treatments because Cigna deemed it “not medically necessary,” please complete the form below.

Cigna Claim Denials (#330)

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Attorneys for this case:

Steven A. Schwartz
Kimberly M. Donaldson-Smith

Photo Credit: Health Insurance Claim Form” by Franchise Opportunities is licensed under CC BY-SA 2.0.