How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

[Dr. Who]

Somebody has to put the info in. People place far too much faith in AI. They pretend it thinks for itself as they tell you that it is programmed to keep out right wing bias? LOL What does that mean. Oh. They program to not do something based on the programmers bias. So the programmers can do whatever they want an you cannot question AI. Crap in = crap out of any program.

As I said, if chicanery is in the programming, it can be audited and then the insurance company would not only be sued for bad faith, it would have problems keeping its license. Insurance companies no longer even keep claims manuals (at least beyond superficial information) because they can be produced in court. Employees can be told to handle claims a certain way, but there is no written record for which the company would then be held accountable.

[LWW]

As I said, if chicanery is in the programming, it can be audited and then the insurance company would not only be sued for bad faith, it would have problems keeping its license. Insurance companies no longer even keep claims manuals (at least beyond superficial information) because they can be produced in court. Employees can be told to handle claims a certain way, but there is no written record for which the company would then be held accountable.

How about bad faith from the gubmint

Remember, OBAMACARE used our need for protection from big pharma and big insurance as justification for requiring us to use big pharma and big insurance; up to and including allowing them to write the rules …and baked in a large profit margin for both industries, while promising us a savings of $2,500 per year.

[stephenpe]

How about bad faith from the gubmint

Remember, OBAMACARE used our need for protection from big pharma and big insurance as justification for requiring us to use big pharma and big insurance; up to and including allowing them to write the rules …and baked in a large profit margin for both industries, while promising us a savings of $2,500 per year.

Forgetting the pubs tried to phckkk it up constantly so it was not remotely what they tried to put in place. Btw it saved me way more than 2500 a year and I kept our doctors.........but it is a mess now as most of the insurance companies kept bailing because I guess they couldnt steal as easily as this thread brings to light. Murica.

[carolina73]

As I said, if chicanery is in the programming, it can be audited and then the insurance company would not only be sued for bad faith, it would have problems keeping its license. Insurance companies no longer even keep claims manuals (at least beyond superficial information) because they can be produced in court. Employees can be told to handle claims a certain way, but there is no written record for which the company would then be held accountable.

By whom? Who is holding them responsible now?

The story is that CIGNA is doing this and individuals are being affected but who is going after them legally?

I don't see how that would change under a programming decision. A class action suit only benefits the law firm in the end. So you still have people having to fight individually against the insurance company that would be claiming AI perfection.

[Dr. Who]

By whom? Who is holding them responsible now?

The story is that CIGNA is doing this and individuals are being affected but who is going after them legally?

I don't see how that would change under a programming decision. A class action suit only benefits the law firm in the end. So you still have people having to fight individually against the insurance company that would be claiming AI perfection.

If the allegations are proven in court, CIGNA will have regulators breathing down their neck.

[DGUtley]

Forgetting the pubs tried to phckkk it up constantly so it was not remotely what they tried to put in place. Btw it saved me way more than 2500 a year and I kept our doctors.........but it is a mess now as most of the insurance companies kept bailing because I guess they couldnt steal as easily as this thread brings to light. Murica.

Forgetting the dems tried to phckkk it up immediately by increasing my premiums but giving me pregnancy coverage with that they put in place.

[donttread]

Forgetting the dems tried to phckkk it up immediately by increasing my premiums but giving me pregnancy coverage with that they put in place.

I had no idea @DGUtley C
ongrats , boy, girl or other?