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
84 thoughts onCigna class action claims software automatically denies large batches of claims without review
Refused to pay for a stroller for my special needs child. Saying we aren’t approving it but won’t deny it either. Which made it impossible to get our co-insurance to pay.
In search of legal advise because Cigna has been a headache for my wife and I for over a year, they will not approve several diabetes medications that they are continually changing meds, and now my wife needs a second shoulder surgery because they continually denied her therapy multiple times that now she has a locked shoulder, her therapist was very upset on how Cigna denied all of their efforts in order to help my wife, now she has received two cortizone shots in order to relieve a lot of the pain, surgery is at the beginning of January again.
Is Cigna Global included?
Cigna denied my claim for short term medical leave when my doctor ordered it due to stress and extreme anxieties which was also affecting my physical health. They refused to approve me for payments while under my doctor’s care which added to my conditions and forced me back to work while mentally and physically ill.
I have about 3 unpaid bills like Simple blood work was even denied like how and I’ve been with them for 10yrs
I also have Cigna, and two times they denied my medical procedure submitted by my doctor once for an MRI need to further look into my excessive GI pains even after the gallbladder surgery and the second time they denied the lab order and test to look into my HPV positive results. Both times my provider and I both had to appeal two times… one is still in process.
I have cigna, every procedure is denied coverage even when it was pre approved by the doctor s office
Please add me. I have cigna and they denied an mri for spinal damage. The treatment delay resulted in permanent nerve damage.
add me as well
Please add me. They denied me