If you paid out of pocket for a medical service or procedure after Cigna denied the claim as not “medically necessary”, you may be entitled to recovery.
Specifically, Scott+Scott Attorneys at Law LLP, is presently litigating against Cigna, challenging its denials of medical claims as not medically necessary through the use of Cigna’s automated claims system known as “PxDx”, which denied claims without a physician’s independent medical review.
An investigation by ProPublica and The Capitol Forum found that Cigna doctors blocked payment for certain tests and procedures by automatically labeling them “not medically necessary.” In two months of 2023, Cigna doctors denied approximately 300,000 claims using the PxDx system, spending an average of 1.2 seconds on each case, according to internal spreadsheets that tracked how quickly they worked.
If Cigna denied a medical claim as not medically necessary, resulting in you having to pay out of pocket for that claim, you may be eligible to join ongoing litigation to recover the money you paid. If you are interested in learning more about the litigation and your potential rights, contact Scott+Scott by filling out the form below.