Recidivists: A Cigna employee by any other name...

Sometimes I wonder why it is that many other people fighting Cigna seem to spend a lot of time quietly waiting around for things, yet we are fighting them almost every single day. Doing some research today for another report that I was working on turned up something that might explain it all.

This is probably not news to anyone but in 2013 Cigna was caught red-handed doing all of the things we know they do and at least judicially had their collective asses handed to them in court.

According to the fantastic summary by law firm Frankel and Newfield PC:

CIGNA disability claims disputes led to a $77 million settlement in 2013 following investigations by insurance commissioners from Connecticut, California, Massachusetts, Pennsylvania and Maine regarding improper denials of long-term disability claims and wrongfully terminated benefit payments.  The settlement also required Cigna to improve their claims handling processes and establish a program to review long term disability claims that had been improperly denied or terminated.

 Now this may sound achingly familiar to many of us but after reading the next section, I was completely blown away. Frankel and Newfield continue (links back to our claim were added by me):

Some of the specific allegations against CIGNA were the following:

1.    Failing to adopt and implement reasonable standards for the prompt investigation and processing of claims arising under its insurance policies;
2.    Failing to represent to claimants pertinent facts or insurance policy provisions relating to a coverage at issue;
3.    Unreasonably denying claims where it was aware that the information it required for potential entitlement to benefits existed but was not obtained or reviewed prior to making the denial decision;
4.    Failing to perform any functional testing or peer review of medical records on file;
5.    Failing to consult with health care professionals who have appropriate training and experience in the field of medicine involved in the medical judgment;
6.    Terminating claims during the “any occupation” definition of disability without performing a transferable skills analysis and labor market survey to identify alternate occupations appropriate to the claimants based on their restrictions, limitations, education, training and experience;
7.    Failing to provide complete information in the file to the health care expert performing a medical review of the records;
8.    Failing to clarify a claimant’s restrictions and limitations with the attending physician who was supporting disability.

That is the entire list as presented; we highly encourage our readers to visit their site and read the whole report.  While nothing on the list will surprise anyone who has ever dealt with Cigna before (think: Scorpion and the Frog), three glaring facts jumped out in our minds:

1. Cigna has done each and every one of these things to us since December 2013. Think about that: every....single.....one. We have evidence of each and every offense. Most of it, Cigna actually gave to us which says they are not in the least concerned with getting caught...and we wonder why we are so busy finding Cigna's mistakes and deceptions.
2. The above list might represent half of the major things they have done and continue to do to us.
3. Since this case was adjudicated in 2013 and yet they continue to do "business as usual", it would seem that the leopard has not changed it's spots a whit.

The only word that comes to mind is the legal one:

Recidivism: 

Recidivism is one of the most fundamental concepts in criminal justice. It refers to a person's relapse into criminal behavior, often after the person receives sanctions or undergoes intervention for a previous crime.

Recidivism | National Institute of Justice

The only thing missing from the definition is "(See: Cigna Insurance)"

The only thing missing from the situation is justice.

To book-end this little bit of judicial drama, the "penalty" phase of the judgment didn't go as some had wished it would. Quoting one last time from Frankel and Newfield:

  As a result of its settlement with the numerous insurance departments who investigated these issues, CIGNA agreed to adopt various “enhanced” procedures, including the following:

1.    Given more appropriate consideration to awards of Social Security Disability Income (SSDI);
2.    Gathering and analyzing medical records for the claimant’s full medical history;
3.    Enhancement of its use and selection of External Medical Resources;
4.     Providing full and complete documentation to its various vocational and medical resources.

Wow, talk about a wrist-slap: 

1. They claim to not give consideration to the awards of Social Security Benefits? In the records from Cigna we found that Richard "Louie" DePalma, Jeff's alleged claim manager basically pestered Social Security until he found out that Social Security had awarded the benefit. Then, within 48 hours the records show him starting the process for claim termination. This was after Cigna had been paying LTD for a year. It was easy to see what was in Richard's mind as he was getting anxious for the reply from Social Security:
   
2. Gathering medical records? First, you are working for them for free. It doesn't matter if the records you send in describe a nuclear reactor in your butt, Cigna has used the fact that you were able to gather and fax records to them as proof that you are not disabled! Even if they don't do that, they cherry-pick the results making what you send them worthless to your case. Don't you hate choices like this?
   
   
3. This is another toothless tiger because Cigna is not following the "enhanced" procedures (stated above) this late in 2014. In our case, they called all of the wrong non-authorized people to get medical updates (and they knew they were wrong) and then claimed with no new information, Jeff wasn't disabled anymore. He had been HEALED brothuhs and sistahs!
   
4. This has GOT to be the funniest reprimand I have ever seen. I mean really, if you don't have feet, you don't buy shoes, right? Remember boys and girls, the reason you are fighting them in the first place? You are disabled (cannot work for the slow readers) and Cigna is supposed to somehow mend it's evil ways by giving you something as useless as vocational training? It is like having prison guards describing the exciting opportunities in law enforcement.
 

 After it is all said and done Cigna not only got off light but as recent history shows, they have not changed their ways at all; if anything they are getting better at it. The only possible reason for a lame penalty such as this has GOT to be the infamous "Chewbacca" defense:

Now it all makes sense....

In the end, Cigna has apparently not stopped doing what they said they were not, and not doing what Cigna claimed they would. It does beg the question: who on Earth would trust them with anything?

Beth Cobb
Cigna War Journal at Gmail dot com