In the latest reminder that you should pursue questionably large medical bills, a group of patients and doctors have filed a proposed class-action lawsuit against Cigna, alleging underpayments of patient claims.
The suit, led by the Litigation Center of the American Medical Association and State Medical Societies, the Medical Society of New Jersey and the Washington State Medical Association, says Cigna knowingly applied lower payment practices for doctors in the MultiPlan Network, a third-party company with more than 1.2 million healthcare professionals. Cigna is one of the largest health insurance providers in the country.
The suit includes several examples, showing a pattern of Cigna’s breach of contract in the interest of saving money. This resulted in both patients and doctors receiving inordinately large bills.
The lawsuit alleges that Cigna “breached its fiduciary duties, including its duty to honor written plan terms and its duty to loyalty, because its conduct serves Cigna’s own economic self-interest and elevates Cigna’s interest above the interests of plan member patients.”
The plaintiffs are claiming these actions violate the Employee Retirement and Income Security Act of 1974 (ERISA).
Holding insurers accountable
This is a high-profile example of what patients and doctors quietly and painfully deal with on a regular basis. Health insurance in the U.S. has mushroomed into a dizzying web of lengthy plan limitations and third-party relationships, resulting in responsibility being cruelly placed on patients to solve problems when they arise.
In some cases, patients are forced to act as private detectives and lawyers to uncover what caused a claim rejection and then fix the problem.
Options for problematic ERISA claims
In a perfect world, you shouldn’t have to spend months chasing paperwork and listening to hold music just to get your insurance company to satisfy their legal obligations. And you certainly shouldn’t be forced to pay more than your shared of medical bills. Speak to an attorney that specializes in ERISA law to learn about your options.