Customer Relationship Management, Search Marketing

Don’t let Cigna get away with Murder

Rest in Peace, Nataline.

If you’ve never been denied benefits, screwed on an insurance settlement, or heard of someone who has – you’re a lucky person! The insurance industry is one of the most profitable in the United States. The math is quite simple, the more people they let die – the better the profits.

Can we change this with the Internet and the blogosphere? Can we literally bombard search engines with messages of Cigna Sucks and make a difference? They claim they are in the business of caring. Is that true? Doesn’t caring actually cost more money than not caring? I believe that Doctors care, but Insurance companies have the opposite incentive.

In a Dec. 11 letter, four doctors appealed to the insurer to reconsider. They said patients in similar situations who undergo transplants have a six-month survival rate of about 65 percent.

Cigna said it was experimental and not covered by their policy.

Nataline Sarkisyan is now dead after three years of battling leukemia and getting denied a needed transplant from her Insurance company, Cigna.

This is nothing short of first degree murder in my eyes. An employer who loses an employee due to unsafe working conditions can be charged with manslaughter or wrongful death, why can’t an Insurance Company? Cigna didn’t ignore the situation, they analyzed it and made a conscious choice to leave the patient to die.

These stories both anger and terrify me. If you own stock in Cigna or even a Mutual Fund that has Cigna in the mix, I would urge you to not support such a company. It’s time that insurance companies quit lining their pockets with the blood of the very people that pay them.

More on Nataline’s struggle:

  1. Nataline passes away, shame on Cigna
  2. Cigna kills Nataline
  3. RIP, Nataline
  4. Nataline is dead

CIGNA Executive Management Team — how do you sleep at night?!

24 Comments

  1. 1
    • 2

      Hi JHS,

      The scary part to me is simply this – an insurance company in this country has the authority to deny claims that a doctor insists would prolong or preserve life.

      A business making a life or death decision should be illegal. Plain and simple.

      Doug

      • 3

        Doug,

        Yes, it’s scary, but it’s been true for a long time. The whole incident is somewhat ironic: Some people have to die because a donor organ just doesn’t come available. Here we apparently had a case where there was one, and she couldn’t get it.

        Or more likely, she could have, but then the rest of her family would probably have to be selling pencils on the street after their own resources were burnt out. Which is why they thought they had insurance. Something is definitely wrong with this picture…

        • 4

          Hi Bob!

          Good to see you here and hope you are doing well.

          Well put.

          I hope we can apply the necessary pressure for our legislature to leave the care of patients where it belongs – with the doctor and not the insurance company.

          Doug

  2. 5

    The problem is that health insurance companies’ bottom line depends on NOT paying benefits. This is what I encountered when trying to get approval for my son’s medication. He had approval for Zyrtec-D, which was a non-formulary medication in 2004 when the battle started. I didn’t. We were both prescribed the same medication for ADHD. Mine was approved; his wasn’t. It didn’t get approved until this year, when Zyrtec-D was approved for OTC sales? Coincidence? You decide.

    Our story is minor compared to this, but the principle still holds. They had covered the bone marrow transplant and aftercare so in their minds, they had discharged their obligation to approve any additional expensive treatments for this girl. I doubt the request initially reached someone knowledgable (see my notes about the gastroenterologist approving psychiatric medications, for example), so it was relatively simple to just say no. Even after the four doctors appealed, they denied.

    Michael Moore has this much right: Putting medical decisions in the hands of anyone other than a patient’s doctor is just wrong. And for the so-called ‘doctors’ at Cigna I just have to ask how they reconcile their Hippocratic oath with the denials they sign.

    • 6

      According to Forbes, H Edward Hanway’s total compensation is $28.82 million and his 5-year is $78.31 million. Hanway has been CEO of Cigna (CI) for 6 years and has been with the company for 28 years.

      That’s how he reconciles it.

  3. 7

    Unfortunately most of us americans go through life fat , dumb and happy . We read about tragedies like this and think it won’t happen to me or my family . We try to downplay its significance with thoughts like ” she fell through the cracks ” or ” she would have died anyway ” . Our press is failing to properly investigate and report on negative and criminal activity by insurance companies because many of the insurers are also paying sponsors . We have reporters such as John Stossel villefying Michael Moores film Sicko just a few short months before Natalines Death .

    Wake Up America

    Until we all become sufficiently outraged and actually make calls , write letters and make our outrage known , these practices will continue . Say it with your pen , your mouth and your pocket book .
    Contact your congressman . Email untruthful news reporters . Contact and threaten to boycott corporations that advertise on these news shows .

  4. 8

    This whole thing raises more questions then answers for me.

    From what I read, if she got the transplant she MAY have lived six more months. She certainly wouldn’t have lived much longer than that. She had a terminal illness.

    I feel for the family. But its not as cut and dry as some media reports want to make it. If it was a matter of her getting this treatment and living for 20 more years… its a no brainer. But getting this transplant, would have required her to get some anti-rejection medicine… which would have taken her already weak immune system and make it even worse… which would have made the cancer spread even faster. AND the cancer was terminal in the first place.

    And I’m going through my own battle with health insurance companies right now myself. So I know they can be down right unreasonable. And my claim is only a couple hundred dollars… nowhere near the six figures this claim was revolving around.

    • 9

      Hi ck,

      I’m sure there are a lot of pieces that are missing, but the bottom line for me was that some doctors and nurses requested the treatment and they were vetoed by the Insurance company. We have to make sure that that NEVER happens.

      Good luck with your battle! I’m one of the many ‘uninsured’ in this country – I’m overweight and can’t get it on my own. (My kids are covered on their own policy).

      Doug

  5. 10

    I trust doctors about as much as I trust insurance companies.

    Wouldn’t you request the ability to do something that would line your pockets with boat loads of money?

    This is why you can appeal to a third party arbitrator for decisions that are denied. So a person who:
    A. Is not influenced by the emotions of the family.
    B. Is not influenced by their bottom line (goes for insurance and doctors)

    Can make the final decision.

    Its not a coincidence that so many doctors are millionaires in their own right.

    So off topic, would you say you support universal health care?

    • 11

      I had the pleasure of knowing quite a few doctors and it was sad seeing how insurance companies affected them. One of my friends was pushed to ‘spend less time’ with each patient to improve his ‘productivity’. I also saw him spending 1/3 of his salary on malpractice insurance (another profitable industry).

      He also HAD to join a Doctor’s group rather than having his own practice because there was no way he could keep up with the insurance paperwork. This was a heart-breaker because he was a fantastic Doctor and didn’t deserve to be tunneled into production line healthcare.

      I think you’ll find that the vast majority of Doctors are not millionaires and even more are leaving patient care because of all the crap they have to deal with. It’s a mess.

      Re: Universal Healthcare

      I lived in Canada for 6 years and I actually do support universal health care (much to the horror of my conservative upbringing). The reason is simple – I believe medicine is a social issue, not a business… even though in the U.S. we have made it a BOOMING business.

      Canada has its challenges, I will admit. The horror stories we hear down here are few and further between, though.

      I believe there’s a great business advantage to universal health care as well – people aren’t afraid to start their own business when they don’t have to worry about healthcare for their families. People are no longer afraid to quit bad jobs, either, leading to improved working conditions.

      I genuinely think it’s a step up. After all, if you can pay an Insurance CEO $28 million a year, there’s opportunity for some streamlining, right?

  6. 12

    Nope. If you see giving 33% MORE of your income to the government for insurance… go right ahead. But as it stands right now… I pay about $250/month for full (very good) medical insurance. Though my employer pays a lot more. But that is part of employing developers.

    • 13

      The irony is that we already do pay that, though, ck. When an uninsured person gets treated, you pay for it through taxes and increased medical rates, etc. We’re already paying for universal health care… but it’s only for treatment – not preventative medicine.

  7. 14

    ck —

    With regard to your comment that Nataline would have had six months WITH the transplant — incorrect. Without the transplant, they’d given her six months on the outside. The bone marrow transplant had succeeded in eradicating the leukemia but the cost was liver damage that was irreparable. If she had received the transplant, she had the prospect of a full life. Without it, she was doomed.

    The system is completely broken when doctors no longer have the ability to be doctors. If you don’t trust them, it’s probably because they have had to practice defensive medicine where they satisfy the insurer, the patient and walk a line down insurance liability risks, too.

    Fixing the system will mean limiting malpractice damage awards and grounds for liability lawsuits, limiting insurers’ profits and putting the practice of medicine back in the hands of the folks who paid over $100K for their education as a doctor. You should really read Dr. Kirschenbaum’s series on Doctors, Money and Medicine for a different perspective. Start here.

  8. 15

    Everything I read seemed to indicate a goal for the liver transplant was a 65% chance of living for another six months.

    Now as my initial post said, if this would have made life for another 20 years possible… all for it. But if its six months… I won’t jump up and down for either decision. And would think the third party arbitrator is a valid solution.

    And while their are issues, I don’t think the fix is universal health care, that just moves the burden to our government and they suck.

    The fix is, as you alluded to… limiting malpractice damages and other regulations. But I certainly wouldn’t put the management of the health insurance in the likes of Hillary Clinton. Frankly, have enough issues with where my tax money gets spent… don’t need it paying for ‘health issues’ like nose jobs.

  9. 16

    CK –

    Per an Associated Press article at http://ap.google.com/article/ALeqM5hFp8DsNC_gJwb9q72kNfDiZCioSwD8TM2SAO1, the doctors at UCLA are quoted as stating “…patients in situations similar to Nataline’s who undergo transplants have a six-month survival rate of about 65 percent.”

    What I understand that to mean is that she would have a 65 percent chance of surviving the first 6 months, and not, as you have noted, that she would die anyway at 6 months. She had a terminal illness because she had liver failure caused by treatment for leukemia. My understanding is that if she made it to 6 months, she would have had every chance to make it several years longer.

    It honestly appears to me from your posts that you believe that health care that can do some good should only be available for those who can afford it, and that everyone else is just better off dead. I do agree with many of your points and suggestions; I think third party arbitration is a good idea, especially if it is speedy, but your perceived notion of “might as well let her die, she was going to anyway” comes off as rather mean spirited. It gives the impression that you are only interested in yourself and no one else.

  10. 17

    Rob,
    I want everybody to live and have access to health insurance, however I don’t think its the place of the government to provide it either.

    I’d rather see much less government (ie, minus the IRS), not more of it.

    How do you think our founding fathers did it? The answer is to make the burden on doctors less (ie law suits) and not to move that burden to every tax payer. Our government has proven itself inept and should not be trusted with our medical lifes as well. With them in charge, cases like this will become more common, not less common. Just look at the stats of heart failure and cancer survivor rates of those with cancer. Private medicine is much more effective.

    But as the to the case at hand, let me say it again.. if the prognosis was for potential to a long life after the transplant… then I’m all for it. But I read the statement you pointed out in the negative way.

    Would really like to see a well written, just the facts style article on it.

    This is not an easy subject and shouldn’t be one waged with emotional arguments. Just the facts m’am.

    • 18

      The Facts are simple, Cigna does not want to spend to cure sickness, the same Cigna Glendale did this to this Family, they fought back in every way they could, only to find out the Goverment Agencies let these people abuse the consumer, and nothing is done. It is covered up.

      Congressman from Valencia, California Writes

      Congressman wrote: In a letter dated May 30th 1996 to Dept of Corporations. Copy of letter provided to Jo Joshua Godfrey.

      Dear Commissioner Bishop,
      I am writing on behalf of my constituents Josephine Joshua Godfrey who have experienced severe difficulties with a California licensed HMO,CIGNA Health care.

      Mrs Godfrey calims CIGNA failed to properly diagnose and treat her lung cancer from March 1993 through August 1994. Apparently a year later non Cigna doctors easily identified the Carcinoid tumor in her left lung and told Mrs Godfrey the Tumor should have been diagnosed in early 1993. Despite repeated denials of the tumors existence from CIGNA, the tumor was ultimately removed at ST. Josephs Hospital in Burbank California. A post operative pathology reports the tumor was “fully grown…fully mature.

      While being examined by GIGNA Mrs Godfrey repeatedly asked to be referred to a specialist for medical treatment. For some inexplicable reason GIGNA refused to consult a specialist for appropriate medical treatment. CIGNA also refused to release Mrs Godfrey’s medical records so another physician could review her medical history and order treatnment. Only after dozens of request were the records released. Yet, Mrs Godfrey believes in order to protect CIGNA from malpractice the documents were maliciously altered.

      The state of California has the responsibility to protect consumers enrolled in HMOS. The state is required to educate and inform consumers about HMOS.With over 12 million Californians in HMOS educating and informing consumers about quality and access to health care is an important undertaking. Unfortunately, if Mrs Godfreys experience is any indication of how consumers medical needs are being treated by HMOS, we must reexamine the managed care system. Congress has begun to probe HMOS and the quality of medical treatment they provide. Many patients believe that HMOS regularly deny care and information to patients in order to cut costs. The apparent “gag rule” which prohibits physicians from suggesting treatment that is not overed by the HMO is also of particular concern.
      My Constituent is not the only individual who has had difficulties dealing with HMO.
      (1)Ruth Macinnes of San Diego died when HMO physicians failed to provide medical tests to diagnose and treat heart disease and respond to cardiogenic shock emergiences;(2) Will Spense of Los Angeles fights for his life bacause non-Hodgkins lymphoma cancer was mis-diagnosed for more than a year. I am told that like these people there are thousands of others accross the nation with similar stories.

      I am respectfully that your office examine these claims, and investigate whether the State’s HMOS are being properly monitered and consumers given the information they need to ensure quality medical care. I believe Mrs Godfrey has been grossly mistreated by a system that should care for her. If violations are uncovered I request that enforcement action be taken against those instutionsn responsible for mistreating consumers. A comprehensive investigation will help ensure that the state fulfills its obligation to over 12 million HMO consumers. Please respond to my district Diretor, Armando E. Araloza at your earliest oppurtunity.
      Department of Corp Reply
      Los Angeles, CA Reply »

      JO JOSHUA GODFREY SHARES WITH THE PEOPLE OF CALIFORNIA AND THIS NATION:
      DEPARTMENT OF CORPORATIONS RESPONSE TO CONGRESSMANS LETTER DATED JULY 2ND,1996
      RE : File No ALPHA
      Dear Congressman,
      I am in receipt of your May 30, 1996 letter, received on June 4, 1996, regarding the above-named individuals and their health care service plan, Cigna Healthcare of California.
      The Department of Corporations (?Department?) regulates Cigna Healthcare and other health care service plans under the Knox-Keene Health Care Service Plan Act (Health and Safety Code 1340 et seq.) and the Commissioner?s regulations (CCR Section 1300.40 et seq.). The Department takes each and every request for assistance (?RFA?) we receive very seriously. RFAs received by the Department are reviewed not only with respect to the individual issue(s), but with an eye towards potential systemic problems as well. RFA review is an important element of the Department?s overall regulatory efforts.
      The Department has reviewed or is reviewing all of the RFAs submitted by the Godfrey family. Josephine Godfrey?s case was reviewed by the Department?s Enforcement Division. This review included, but was not limited to, a through examination of relevant medical records, interviews with plan personnel, and extensive discussion with the Godfrey family. As a result of this review, the Enforcement Division determined that Cigna had satisfactorily addressed Mrs. Godfrey?s specific complaints and had developed strategies for resolving these problems.
      As to Christopher Godfrey?s RFA, Cigna agreed to have (Name of individuaL Omitted) R.N. available to both Mr. and Mrs. Godfrey to assist them in the coordination of their current care and resolve any problems they may encounter. Both of these RFAs are now closed. However, the information in these and all RFAs is incorporated into the Department?s ongoing regulation to ensure health plan compliance with the Knox-Keene Act.
      The Department shares your concern about so-called ?gag? clauses in provider contracts. The Department recently required a plan to delete a clause in its provider contracts which obligated the provider to put the plan in a ?good light.? In a recent communication to all licensees, the Department stated:?Each contracting physician and other health care professional should be able to speak honestly an accurately about matters which may affect a patient?s health and will-being to foster the traditional relationship of trust an confidence between patient and health care professional.?
      In closing, I wish to again emphasize the Department?s commitment to the millions of Californians enrolled in health care service plans. Should you have additional questions, please do not hesitate to contact Special Assistant (Name Left out)Sincerely,
      KEITH PAUL BISHOP
      Commissioner of Corporations

  11. 19

    I wrote this story to Legislators when I was 14 years old,and I want to share it with you.

    I am 14 years old and I am a victim of medical malpractice. I am writing to the Congress and the Senate because you need to help the victims of medical malpractice. I was ill, my head hurt and my mom took me to the doctor. I had frequent nose bleeds and bad headaches. I think this started in the end of 1992 or early 1993. They said I was okay, and I remember one doctor was so mean to my mom and me; she didn?t even want to talk about it. She said it was all in my head, that I was okay. 1993 and 1994 were not good years in my life. I was unhappy. My mom was always sick, always in bed coughing, always going to CIGNA getting medicine, always too tired. My mom was not the same mom any more; my head hurt on and off, and I tired not to bother my mom as I could see how ill she was. She was always depressed, always crying, and always moody and coughing. I would yell at her to shut up at night and she kept us all awake, now I feel bad.

    In February 1994, I was depressed, my head was hurting, and I took pills from the medicine cabinet, it wasn?t the first time I did this, but my mom was sick she didn?t even notice. Each time I took more and one day my mom came in to wake me up and I wouldn?t get up, I was too tired. My mom said that?s it, get dressed; we are going to CIGNA right away. I went there and CIGNA doctors saw me. They sent me to a mental health place and neither of these two places even knew what I had done. My mom walked me about and I told her what I ad done. Later that day she said how could she live if I died. My mom cried because she was so tired she blamed herself because she wasn?t doing enough. I made my mom a promise not to do this again. My mom called CIGNA and got upset about how they failed to see I had tried to kill myself, asking them what kind of doctors they were. My mom screamed so much they agreed to give me a complete physical. At the physical in early March, we complained so much about my head they agreed to do scans of my head. This went on for about two and a half months, one scan after another, and finally the doctor said I needed to have my sinus washed out, that was in the end of May. My mom asked if this was urgent, did it need to be done right away, the doctor answered it was not urgent. My mom said we would have it done in the summer vacation.

    From May to August, my mom got very ill. She went to the doctor and they put her on disability for 6 weeks. In the middle of July, I had a dream that my mom had lung cancer and she was going to die. My mom got very upset when I told her this. By the beginning of August, my mom sent me to Ireland for one month to visit my grandparents. When I came back from Ireland in the end of August, our home was in an uproar, for 2 weeks CIGNA had refused to give my mom all her x-rays telling her they were lost. She had just got them and it showed she had the lung cancer for almost 2 years. My mom had an operation and 20% of her lung was removed. She had a carcinoid tumor. When my mom was in the hospital, the surgeon told my step-dad he was not well either. It ended up that CIGNA refused to release my step-dad?s records for 2 weeks. When they went to an outside doctor, CIGNA had been treating him for asthma; he really has a very advanced case of COPD and had something on his left lung like my mom had.

    We went and got the records for all our family. When we saw mine, and we went to an outside doctor, after going outside doctors I know now what the difference is between a real doctor and a CIGNA doctor is, and I hope maybe one day I?ll get to tell you all about that. I had a problem where the bone was being destroyed, where the bone was pushing through the orbit, and the doctor said my eye would have been pushed out. I had my surgery at Cedar-Sinai. 1995 is not much better that 1993 as there seems to be no justice for all these things that CIGNA did to us. We want to get the laws changed so no one will ever have to suffer like this again. CIGNA abuses our family to this very day. They make my mom cry for hours and I hope you will let me tell you all about this too. CIGNA should also know if my parents die, where will I go, and what will happen to my brother and sisters? I?m an American, and when I grow up, I don?t want to live here. I want to move to where people are good and kind. I?ll move to Ireland.

    Now I am 27 Years old. However it is pretty sad that any family would have had to suffer this way, and these crooks and swindlers escaped punishment in the State of California.

    THANK YOU CIGNA GLENDALE

  12. 20

    Testimony Senate Rules Committe Hearing State of California Monday May 12th,1997 at 2.03PM
    I have come to share my experiences with you. The Department of Corporations is failing in its regulatory function, and my familys experience illustrates that. And my own personal experience with Cigna Healthcare will illustrate how consumers are being abused, and how the Department of Corporations is turning a blind eye.
    My experience with Cigna began with the abuse of my parents, and in turn they perpetrated that abuse against every member of my family. When I was sick and needed a physician they would send me out on an appointment, and I would be humiliated because most often the physician where they sent me was not expecting me. As a result Cigna sent me a letter saying that I could choose my own physician and they would pay for the medical care. They did this once and then they did not pay for the medical care, and I was threatened by collection agencies that I would be sued if I did not pay the bill. Cigna also said that I could choose a doctor of my choice in my place of residence Santa Barbara, and this never happened. Cigna assigned me a dostor in Santa Barbara but when I was sick and wanted to make an appointment and I called the doctor she never returned my calls. When we contacted the doctors office they said they did not work with Cigna anymore, because Cigna would not make referrals when specialists were needed.
    Last year I needed specialty care, and during the procedure the doctor said I needed a Biopsy. He had to stop in the middle and get authorization from CIGNA to continue. The doctor said the two procedures were linked and he had never been expected to perform MEDICINE in this way before. After this procedure when I complained to the Department of Corporations about this Cigna denied the accusationsand responded that the doctor was mistaken. Since that time the doctor came forward to his Legislator in Santa Barbara he stated he performed the Biopsy without their authorization,and my account of the incident was correct. The doctor said I needed follow up every 90 days as this was a pre cancerous condition. Cigna said if I needed this specialty care I needed to go through the primary care doctor to make sure I needed it, and they in turn assigned me a primary care Doctor in Santa Maria, not even in the same County, and more that an hour from my residence.
    I am a student I go to UC Santa Barbara, and I do not have transportation. It is just not a viable option., and the Department of Corporations instead of assisting me, had the person at Cigna that was responsible for harassing me and obstructing my treatment call me again

  13. 21

    After recently having United for many years my company has switched to CIGNA.I recently had to have an MRI on my back and was told by the DR.s SEcretary CIGNA is so bad on authorizing anything.It took 5 days to approve it,but only after my doctor had to literally beg.I was also told even if they approve procedures,they sometimes turn around and deny it saying it was not authorized to their specifications,and you are then stuck with the bill.To make matters worse I received a call from CIGNA tonite to see if I would be interested in calling “THEIR NURSE” for future lung,heart,back, or bone problems in the future rather than going to my PCP!! I told them I would not be comfortable being “seen” over the phone and thank you anyway.She was very upset sounding I did not jump at the offer.

    I am absolutely terrified of any future medical issues I need addressed especially that I have a 7yr old,and CIGNA seems like an uncaring company after reading the comments.I can only pray we all stay healthy,because CIGNA is out for the penny not the patient!!!! This was made clear to me in just 1 week!!!!!!!!!!!

  14. 22

    i work for a major airlines with cigna as my ins. i fractured my back at work, on the job, clocked in. this hanger manager tells me that this is ” NOT ON THE JOB INJURY” !!
    i lost my ins ” long term disability” thru cigna. well, they – cigna sent me to this whore of a physical therapy that told cigna what they wanted to hear. so, im laying on my back with no help and in pain with no income. who has the answer and if any one wants a phonme number to call, because i people of passing the buck and i must have a draw of numbers to call, all of which didnt help but boy do they have phones numbers!!
    in closing, kiss my ass for those that apply, for those that its doesnt, im sorry for your pain and lost of life

  15. 23

    My mother has been passed away for 11 years and Cigna is the insurance she had when she was in the hospital for the Flu. After a short period of time she became worse while in the hospital but instead of getting better treatment we got a visit from a lady that worked for the hospital and told my mother and I that my had to go home because Cigna would not be paying for anymore of her stay. My mom was only 55years old when Cigna booted her out of the hospital. We did not know but Cigna which had to know due to medical records had to be sent to them for any type of payment to the hospital that my mother had bowel stuck in her intestine that is why she was bleeding from the rectum and couldn’t stand on her own when she was told Cigna said they would not pay for anymore treatment. My mom would go back within that week to the ER so sick that they couldn’t take her blood because she would of died right then so she was put in ICU and then is when we found out that she had bowel stuck in her intestine that she would need surgery but since it was not done sooner she was opened to being infected almost all her intestine from the bowel just sitting there because my mom did not know she had this but Cigna did when they tossed her out of the hospital. She was then put on life support and less than 7 days later 18 days before I would turn 21years old I had to sign for my mother to be taken off life support because there was no hope due to how fast the infection had spread while she was out of the hospital. Call it what you like but it is murder when money or the right insurance would have kept my mother alive but since she had CIGNA HMO they decided she was not worth paying for. Still 11years later I still wonder how many others died in their hands.

  16. 24

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