Top Class Actions’s website and social media posts use affiliate links. If you make a purchase using such links, we may receive a commission, but it will not result in any additional charges to you. Please review our Affiliate Link Disclosure for more information.
Cigna claims class action lawsuit overview:
- Who: Hannah Veinbergs filed a class action lawsuit against Cigna Corp. and Cigna Health and Life Insurance Co.
- Why: Veinbergs claims Cigna uses an algorithm to automatically deny payment requests for necessary medical procedures en masse.
- Where: The class action lawsuit was filed in California federal court.
Cigna systematically, wrongfully and automatically denies insurance claims for patients needing necessary medical procedures that are owed to them under Cigna’s health insurance policies, a new class action lawsuit alleges.
Plaintiff Hannah Veinbergs claims Cigna has developed an algorithm that enables its doctors to “automatically deny payments in batches of hundreds or thousands at a time for treatments that do not match certain preset criteria.”
The plaintiff argues the algorithm, called procedure-to-diagnosis — or PXDX — is able to evade the legally required individual physician review process for insurance claims.
“Relying on the PXDX system, Cigna’s doctors instantly reject claims on medical grounds without ever opening patient files, leaving thousands of patients effectively without coverage and with unexpected bills,” the Cigna class action states.
The plaintiff wants to represent a nationwide class and California subclass of individuals who have purchased health insurance from Cigna, from the beginning of the applicable liability period to the present.
Cigna doctors denied more than 300,000 payment requests using PXDX method within two months last year, class action says
Veinbergs claims Cigna doctors denied more than 300,000 payment requests using its PXDX method over a period of two months last year, while allegedly spending an average of only 1.2 seconds “reviewing” each request.
“Cigna failed to use reasonable standards in evaluating the individual claims of Plaintiff and the Class members and instead allowed its doctors to sign off on the denials in batches,” the Cigna class action states.
Veinbergs claims Cigna is guilty of unjust enrichment, intentional interference with contractual relations and breach of the implied covenant of good faith and fair dealing, and of violating California’s Unfair Competition Law.
The plaintiff is demanding a jury trial and requesting declaratory and injunctive relief along with an award of, compensatory, incidental or consequential damages, and punitive or exemplary damages for herself and all class members.
A separate complaint was filed against Cigna in 2017 — and unsealed in 2020 — over claims the company submitted fraudulent claims to Medicare Advantage and overbilled by more than $1.4 billion from between 2012 and 2017.
Have you purchased health insurance from Cigna? Let us know in the comments.
The plaintiff is represented by Michael R. Reese, George V. Granade and Charles D. Moore of Reese LLP, and Kevin Laukaitis of Laukaitis Law LLC.
The Cigna claims class action lawsuit is Veinbergs v. Cigna Corp., et al., Case No. 3:23-cv-01540, in the U.S. District Court for the Southern District of California.
Don’t Miss Out!
Check out our list of Class Action Lawsuits and Class Action Settlements you may qualify to join!
Read About More Class Action Lawsuits & Class Action Settlements:
- San Francisco Archdiocese files for bankruptcy after flood of new sex abuse lawsuits
- Unum data breach affects half a million consumers, class action claims
- 1st Auto & Casualty Insurance sales tax $788K class action settlement
- Equifax, Experian, TransUnion identity theft credit damage or inaccuracies recovery lawsuit investigation
Honda, Hyundai, Kia, Subaru vehicle data collection class action lawsuit investigation
May 17, 2024 | Legal News
84 thoughts onCigna class action claims software automatically denies large batches of claims without review
I had CIGNA in 2020 and dropped them for 2021 as a result of far too many problems and claim denials.
Denied stating paperwork was incorrect. Still appealing. They want me to pay out of pocket
I also have Cigna, I have for 5 years
I have been denied tests for my back surgery and now my disability has run out and my back keeps getting worse…. Over and over again I was denied after begging for a year !!! Dr said without the surgery I’ll end up in a wheelchair and or paralyzed… now having to go back to work without treatment after complying with everything Cigna asked for…. Meds and physical therapy that only made it worse!
Please include me in suit. Blood tests denied as unnecessary. Have been with them since 2017.
Requesting inclusion for this lawsuit review for Cigna denial information. I even have a current issue with Cigna.
Include me in the CIGNA suit. I have been with them since 2011
Yes I had Cigna Group Health I pd for many years up to 2014 pls add me to your list for additional information on this issue. Thank you.
I had preemie twins (3 lbs 10oz and 4lbs 11oz). You cannot leave the hospital unless your kid can pass a car seat test. You cannot buy a car seat for a child under 5 lbs (not that I could find and not like they would have passed it anyways). My daughter was on a feeding tube and my son kept having Brady’s (when he would fall deep asleep he would forget he was supposed to be breathing and just quit, alarms go off, nurses rush in, the whole nine). They denied the month long NICU/PICU hospital stay and said it “was not medically necessary”. How in the heck was it not medically necessary? They couldn’t survive without tubes and sensors and specialized providers. We didn’t even get a chance to hold them after being born, they were immediately rushed off with each their own team of people. The twins hadn’t even made it out of the hospital yet and I got a bill for almost half a million dollars because they denied it all. The amount of stress that added to an already stressful situation. The amount of phone calls it took, I mean hours and hours of my time, time that should have been spent caring for my babies instead of arguing on the phone in the hospital hallways with them.
We had to do invitro because of a medical condition I had. Policy stated they would cover one successful round up to a lifetime maximum of $25,000, which they did. What they didn’t do was cover the $2500 worth of drugs I needed from this little mom & pop pharmacy in Raleigh. I cried and was defeated, we didn’t have the $2500. Then I got mad, all this money a month we were paying them. So, I found the exact verbage in my policy, like 300 pages deep, that stated the drugs would be covered and quoted it. After a very very long hold, someone gets on the phone and says “you’re right, we made a mistake, we will cover it but it must come from Cigna’s pharmacy and it’s going to be $5000”. Obviously, trying to eat away at that $25000 lifetime maximum. How can a pharmacy for an ENTIRE insurance company with all those customers have drugs prices that are double some little rinky dink, one shop, mom & pop pharmacy with probably under 100 customers? That just didn’t sit right with me. None of it does. Joke was on them because I came in at $19,895. HA! Plus ended up with twins so literally bought one, got one free…sorta. Must have pissed them off because they sure socked it to me with the hospital stay.
Add me, had Cigna for over 5 years
Add me.Had Cogna for years/ premium poplivy. Bills not paid. and meds denied.
I’m