AUGUSTA (AP) – The Maine Bureau of Insurance has fined Cigna Healthcare of Maine Inc. and Cigna Behavioral Health $900,000 for multiple violations of state law.

The fine is the largest ever levied by the bureau.

A spokeswoman said Cigna acknowledges it had serious service problems, but has “made great progress in improving our service.”

Cigna must also pay affected claimants for interest due for late paid claims, estimated at $915,000 for 2001 and 2002. For prior years it must provide additional unpaid interest for claims processed from Sept. 18, 1999 , to Jan. 1, 2001.

For more information, go to www.maineinsurancereg.org

The companies have until the end of January to calculate the additional interest due. The aggregate amount for the four years will be the largest restitution award ever obtained for claimants by the state insurance bureau.

Besides the fine, the state is mandating that the company improve its complaint handling, grievance procedures, records retention, failure to actively market individual health plan coverage, and member notification about plan cancelation.

The state says one of its most startling findings was that Cigna’s own grievance review process overturned initial claim denials, when appealed, a significant percent of the time.

The consent agreement requires that Cigna file a plan of correction action with the insurance bureau by Dec. 31 that addresses each violation of law.

On the Web:



www.maineinsurancereg.org

AP-ES-12-12-03 1442EST



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