Anne Bucher  |  November 1, 2013

Category: Legal News

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Cigna LawsuitA Pennsylvania federal judge gave preliminary approval to a $2.4 million class action settlement that would resolve a dispute between Cigna Corp. and a nationwide class that accused the company of improperly denying benefits for some types of autism spectrum disorder treatment.

On Oct. 31, U.S. District Judge Juan R. Sanchez approved the proposed class action settlement, which would provide compensation to current and former Cigna insurance policyholders who claim that, starting in Nov. 2004, they were denied benefits for their children’s autism treatments that had been deemed by Cigna to be “experimental, investigational or unproven.” Class Members will be able to submit claims for reimbursement for the treatment that was denied by Cigna.

Plaintiff Kristopher Churchill initially filed the class action lawsuit in 2010, alleging that Cigna has a policy of classifying Applied Behavior Analysis (ABA) as an experimental autism treatment and does not provide insurance coverage for the treatment. Churchill argues that ABA is a well-recognized and scientifically valid form of treatment for children with autism. It is backed by the U.S. Surgeon General and the National Institute of Mental Health. When the class action lawsuit was filed, 26 states, including Pennsylvania, mandated insurance coverage for ABA treatment.

Under the terms of the proposed class action settlement, Cigna has agreed to produce a list of all individuals who were enrolled in a Cigna health plan and made a claim for ABA for autism spectrum disorder that was denied because the treatment was deemed to be “investigative or experimental” since Nov. 24, 2004. Cigna will also provide a list of all individuals who participated in the NetApp Medical plan whose coverage or rider provided by Cigna for ABA for autism spectrum disorder was denied since July 1, 2011.

The $2.4 million class action settlement fund will compensate an estimated 350 to 400 Class Members. A final approval hearing has been set for Feb. 9 in the U.S. District Court for the Eastern District of Pennsylvania.

Judge Sanchez appointed Class Action Administration Inc. as the Settlement Administrator. Under the terms of the class action settlement, the Settlement Administrator has 30 days to notify potential Class Members about the settlement, who will have five months to submit a claim.

Further information about the Cigna ABA Claim Denial Class Action Settlement was not immediately available. Please keep checking Top Class Actions for details on how to file a claim or sign up for our free newsletter below.

The plaintiffs are represented by Gerard V. Mantese, Brian M. Saxen and David F. Hansma of Mantese Honigman Rossman & Williamson PC; Gregory B. Heller of Young Ricchiuti Caldwell & Heller LLC; and John J. Conway of John J. Conway PC.

The Cigna ABA Denial Class Action Lawsuit is Churchill, et al. v. Cigna Corp., et al., Case No. 2:10-cv-06911, in the U.S. District Court for the Eastern District of Pennsylvania.

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One thought on Judge Approves $2.4M Cigna Autism Denial Class Action Settlement

  1. LaKisha Mamon says:

    Has Cigna resolved to make changes to ABA coverage? I am currently being denied services for my child who was diagnosed with Autism and through the diagnostic process since 8/2012 services including physical therapy/occupational therapy were denied. I sought speech services privately after speaking with providers and Cigna rep that services would be denied. Cigna Autism Case management is now saying that ABA is not covered even to this date.

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