CIGNA

Thank you for forwarding this complaint to Cigna. Please be advised a written response was sent to the customer on 4/30/2015 and again today (6/4/2015).Charlene V[redacted]Executive Office Advocacy Team

[redacted] HHHH[redacted]




4:02 PM (3 minutes ago)










tome




 
 
 
 
 
[redacted],
 
I sent an electronic response/update to the Revdex.com earlier today under Revdex.com # [redacted] in error. The response that I sent does not apply to this Revdex.com. Please disregard.
 
Revdex.com [redacted]
[redacted]
 
We are still working on the Revdex.com for [redacted] and hope to bring it to resolution in the next few days.
 
[redacted] CTT+ 
Executive Office Advocacy Team
Executive Office of the President
Cigna
Phone: ###-###-####
Fax: ###-###-####
[redacted]

Cigna contacted [redacted] at the telephone number listed on Revdex.com # [redacted] and left a voicemail message. This has been resolved.

Thank you for this information.
A written response was mailed to the customer on August 3, 2015.
Thank you,
Nicole P[redacted]

[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 [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

Hello,This complaint was received by Cigna's Executive Office Advocacy Team. We will research the issue and follow up with the customer directly.Thank You,Rafael P[redacted]

[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 [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

Cigna is reviewing this matter and will respond with additional information.  We take patient confidentiality seriouslyProtecting our customers’ personal health information is critical. So 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 [redacted] to give us permission to share our findings with the Revdex.com. [redacted] can grant this permission by signing the attached Authorization for Use and Disclosure form. Erica *. M[redacted]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 response. If no reason is received your complaint will be closed Administratively...

Resolved]
 Complaint: [redacted]
I am rejecting this response because:  I just received another delivery {order number [redacted]} and was charged $12.87.  Generic medications require a zero co-pay
Regards,
[redacted]

Thank you for this information.  I am having this reviewed by the account manager.  Once resolution has been reached, customer will be contacted.
 
Thank you,
Kelly Mertz

March
23, 2016Dear
[redacted],We
are writing in response to your March 14, 2016, inquiry regarding [redacted]s
Long Term Disability (LTD) claim. [redacted] was covered under his
employer-provided fully insured LTD Policy LK [redacted], which was underwritten
by [redacted]...

[redacted] ([redacted]) and issued in the state of
Massachusetts.We
understand that [redacted] feels his claim was closed prematurely. [redacted]
thought that there was a retroactive change to his policy which amended the
maximum benefit period to allow for three additional months of LTD benefits. As
of March 23, 2016, there has been no such change to his employer’s policy or its
benefit duration which would allow for these additional benefits. [redacted]’s
LTD claim manager previously discussed with the customer that if such a change
were made, than his LTD benefits might be able to be extended. However, no
amendment to the policy occurred. Policy
Number LK [redacted] includes language which limits [redacted]’s LTD coverage to
24 months of disability benefits. It was determined during our review of the
customer’s claim that he would have been considered disabled starting on
January 29, 2014, with benefits commencing on April 29, 2014. Disability
benefits were paid to [redacted] through April 28, 2016, the maximum benefit
period for his disability. Therefore, as 24 months of benefits have already
been extended, no further benefits are payable under the policy.We regret any confusion that may have occurred with [redacted] thinking there had been a change to his policy. On February 3, 2016, our
claim manager spoke with [redacted] by telephone to confirm there had been no amendment
made to his policy which would extend his LTD benefits further than April 28,
2016. Our claim manager also discussed with [redacted] his option to file an appeal
should he disagree with our claim determination.
Should [redacted] wish to file an appeal or  has additional questions on the process, he
may contact the claim manager who made the determination on his LTD claim
directly. Should
you or [redacted] have any questions or would like to discuss this matter
further, please feel free to contact me directly at ###-###-####.  Sincerely,Eric F[redacted]Compliance
SpecialistCGI
Consumer Advocacy

Hello-Thank you for forwarding this complaint. Cigna will review and follow-up directly with the customer. Thank youTanya H[redacted]Cigna's Executive Office of Complaints

We have sent a response to the customer in regard to Revdex.com# [redacted]. The response was sent today.

Claimant’s
Name: [redacted] Policy
Number: VDT [redacted] Policy
Holder: Lake County Board of County Commissioners NAIC
Number: [redacted] CGI
Incident Number: [redacted] CGI
Matter Number: [redacted] Underwriting
Company: Life Insurance Company of North America Dear
Ms. [redacted],We
are...

writing in response to your March 28, 2016 inquiry regarding Mr.
[redacted]’s Short Term Disability (STD) claim. Mr. [redacted]
is covered under his employer’s STD Policy VDT [redacted], which was
underwritten by Life Insurance Company of North America (LINA) and
issued in the state of Florida.We
understand that Mr. [redacted] is concerned with the time it has taken
to complete the review of his STD claim. Mr. [redacted]’s claim was
received on March 14, 2016. 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
provider. Records needed for our review were then requested from Dr.
Austin.Upon
receipt of Mr. [redacted]’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 reached. Our STD claim team
confirmed that information was still needed from Dr. Austin. As of
April 1, 2016, a response has been obtained and Mr. [redacted]’s
claim is currently being reviewed by our STD Claim team. Mr. [redacted]
will be promptly notified of the outcome of our review, once a
decision has been reached. If additional medical information is
required from his providers, he will also be notified of this fact. As
Mr. [redacted] was advised in our March 21, 2016 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 file. Should you have any questions or would like to
discuss this matter further, please feel free to contact me directly
at (412) 505-7184. Sincerely,Eric
F[redacted],Compliance
SpecialistCGI
Consumer Advocacy

We have sent a written response to the customer in regard to Revdex.com # [redacted]. The customer should receive the letter within 5 days.

Thank you for forwarding this complaint to Cigna. Cigna has reviewed this complaint and resolution has been met . I have outreached the member to provide resolution through telephone. At the time of contact, I was unable to reach the member but left my direct number for a call back. Erica...

M[redacted]Executive Office Advocacy Team

February 2, 2016 Dear Sir or Madam:We are writing in response to your correspondence dated January 25, 2016, referencing [redacted] claim for Long Term Disability (LTD) benefits. [redacted] was covered under his employer's fully insured LTD group benefit policy [redacted]. This policy was underwritten by [redacted]) and sitused in the state of Massachusetts.[redacted] raised concerns regarding his most recent LTD claim experience and claim decision. Please allow us this opportunity to address his concerns, explain our decision, and provide an updated status.With respect to [redacted]'s employer's LTD policy [redacted], in order for benefits to be payable, as of November 27, 2015, his medical records needed to support that his health conditions caused a functional impairment that would continuously prohibit him from performing the material duties of any occupation. The policy's "Definition of Disability/Disabled” lays out these requirements and is defined on page 2 of the enclosed policy.While his LTD benefits were approved for a time, continued LTD benefits were not payable to [redacted] beyond November 27, 2015, because he no longer met the policy’s definition of Disability. This determination was based on our ongoing medical review of the relatively stable findings received from his providers. After a complete medical review of the available records on file, it was determined that [redacted]'s condition would not render him Disabled beyond the date referenced above, according to the terms of his LTD policy. As a result, no further benefits were payable and his claim was closed. On September 3, 2015, a letter was sent to [redacted], which explained our decision, provided information that may be helpful to perfect his claim and further explained the appeal process.Subsequent to our decision, [redacted] requested an administrative appeal review of his LTD claim. As part of our process, his entire file was referred to an independent peer reviewer for evaluation.For your reference, we have enclosed a copy of LINA's recent correspondence to [redacted], explaining that our prior decision on his claim was overturned on appeal. After reviewing updated medical

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
 Complaint: [redacted]
I am rejecting this response because: they did tell me to go through neurology to get developmental peds otherwise why would I take my daughter to the neurologist when she had no neurological symptoms (i.e. Sezuires) 
Regards,
[redacted]

Thank you for this request, a letter was sent to customer directly.
 
Thank you,
 
Kelly M[redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed...

Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because: When was the issue of money being taken from my account without my authorization ever resolved? My account was in the negative because that mistake and I was never returned what I am owed. If the rolls were reversed and I owed your company money, you people would've sent my account to a collection agency by now. An incompetent firm with apathetic, insincere employees screws me over, and all I'm offered is a mediocre apology with no assurance of repayment. The issue was "addressed," but not RESOLVED.
Regards,
[redacted]