Cigna Ordered To Pay $13M For Refusal To Cover Claims

By Shayna Posses (June 1, 2016, 9:54 PM EDT) -- A Texas federal judge awarded a physician-owned hospital more than $13 million in litigation against Cigna, concluding Wednesday that the insurer breached the terms of benefit plans by refusing to cover out-of-network health care services provided by the facility.

U.S. District Judge Kenneth M. Hoyt shot down Cigna Health and Life Insurance Co.'s claims that Humble Surgical Hospital LLC inflated its bills, instead finding for the hospital on its counterclaims, pointing out that the insurer didn't allege that the facility performed unnecessary medical procedures or performed them negligently.

The judge wasn't swayed by Cigna's argument that the hospital engaged in fee-forgiving and other...

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