CIGNA dirty tricks or just a coincidence - YOU decide!

One of our readers, Darvin, comments on a previous entry:

I found your blog rather interesting. Cigna Insurance is one of the few insurance companies which does not have too many negative reports. It seems to pay out the reimbursement in time, in full amount. The customer service is also impressively good. www.pissedconsumer.com though displays people’s dissatisfaction with the company. Obviously, there are some gaps in the way the company provides its services.

He/she also writes exactly the same comment at Shakespeare's sister's blog.

I found your blog rather interesting. Cigna Insurance is one of the few insurance companies which does not have too many negative reports. It seems to pay out the reimbursement in time, in full amount. The customer service is also impressively good. www.pissedconsumer.com though displays people's dissatisfaction with the company. Obviously, there are some gaps in the way the company provides its services.


Darvin? Care to explain?

Updated:

I'm surprised that Darvin is located in the Ukraine and has such an active interest in CIGNA. Our blog log shows that he/she connected from Ukraine, Kiev, Kyyivs'ka Oblast'. My guess is that he/she is using an anonymizer. I'm not sure then why the name Darvin would be used.

Tim

Another Grand Canyon?

Australia has its own Grand Canyon. I hiked it last weekend with some friends, Robert, Sandra, and Connie.

Grand is perhaps too strong a word. I'd call it Deep Canyon - it's very narrow and deep. So much so that my GPS didn't track very well. Here's the Google Map showing the parts where I had a reading:


Here's a warning sign:



Here's a view along the footpath:



The bottom is wonderfully dark and damp. The path goes up and down the side of the canyon, sometimes close to the top and sometimes at the bottom so it's quite a hike. We saw lots of people, most hiking but a few were obviously going to climb down.



The temperature was in the teen's when we were there. The bottom of the canyon would be a good place to spend a hot day but getting in and out would raise your own temperature a lot.

Here's a picture taken looking up from the path:



The guide books call this a half day walk but we did it in a couple of hours. I'd guess it was about 5km. There's a nice view at the north end of the loop shown here. The view from here really is similar to the view from the north rim of the Grand Canyon in the US - one of our favorite places to car camp.

Tim

Why we miss New Mexico....

Musings...

So... as one ages, does one get dumber or does one get wiser and just truly begin to realize how much one really doesn't know? Put another way, am I losing smarts or gaining self knowledge? Hmmmm.

We had four Kookaburras outside our balcony yesterday. They are funny birds. They usually don't find Tim or I very interesting since we are fish eating vegetarians, but someone suggested dog mince to me - and well, they like us more now. When it comes to food, these birds know no fear. One Kookie (as they are endearingly called here) flew right up to me to grab the mince. This is what they sound like. And here's a photo I got the other day:

















It's not a great photo, but it was overcast.

Here's a photo of a Sulphur-Crested Cockatoo. He was just a foot away from me.... speaking of fearless!



When these birds arrive I do battle with them to scare them away. They are known to destroy timber homes if you stop feeding them. They are beautiful though.

Judi xxoo

The second best version of Hallejuah

A group from Norway has the best version (after k.d.) - who'd have thought it?

Espen Lind(on guitar), Askil Holm, Alejandro Fuentes, Kurt Nilsen(World Idol). Wait for the last singer!

Caminito del Rey

Enough with the rain already!!!!!!!!!!!!!!!!

I'm really sick of it. It has been raining for weeks here. I realized that I'm not turning gray, it's just mold growing on my head.

And let me tell you about the leeches! Yuck. Last week, Tim took the dogs for an hour long bush walk. It wasn't raining at the time, but it has been raining as I mentioned. When he came home, I noticed a couple of leeches that had dropped off the dogs. They weren't engorged - meaning they hadn't yet feasted on my dogs' tasty blood - but still skinny stretching slinky alien lifeforms. It's hard to like a leech. Anyway, I thought I might rub the dogs with some special doggy insecticide I have to encourage any "hangers-on" to exodus my doggys' bodies. We've had leeches before, but I still wasn't prepared for the plethora of squiggly critters to jump ship (I mean, dog). I must have picked up 20-30 leeches! Now ask me, did I flush the leeches down the toilet?

Funny you should ask....

The last time a leech dropped off one of the dogs, Tim flushed it down the toilet. Jumping ahead (no pun intended - :) ) 20 minutes, I had just finished relieving myself and turned to flush. Have you ever had the experience of something you just deposited in the toilet coming back atcha? Well, you might have guessed what my first impression was, but it actually was the "flushed" (and may I say very good swimmer) leech! It had crawled up the inside of the toilet and was stretching its disgusting self toward where my very "personal" self was just exposed. Are you getting the picture here?

I know that some celebrities, with way too much money and time, actually pay to have leeches placed on their bodies. I know that surgeons use leeches in lifesaving heart surgery. But wouldn't a leech be the epitome of a hemophilia's nightmare?




Personally, I don't like 'em, but if you want to learn more, try here.

-Judi

Australian Private Health Insurance

Tim and I took out private health insurance here in Australia. We became eligible for Medicare - Australia's public health insurance - in October. Even with the public health program, many people who can afford it, take out private insurance as well. For one reason, there is a tax rebate for people with private health insurance. I assume the reason is that private healthcare relieves some of the stress on the public system.

There is a general rule here, that if you have had hospital coverage prior to enrolling in a new program, that your benefits will continue if you enroll within two months of terminating your last insurance (hence no 2-month waiting period or pre-existing condition clauses). There is some question whether our expatriate coverage that was provided through CSIRO (until Medicare became effective by becoming permanent residents) is eligible for this 2-month continuation rule. The interesting item here, is that our new health insurer is helping us get that continuation of coverage - i.e., save us money which could potentially cost them money!

Comparing this to our experience with Cigna - well, in fact there is no comparison! I had to fight Cigna for almost every claim I ever made, which usually meant dealing with some very unpleasant (read: rude and abusive) Cigna employees.

I know that the USA doesn't have public health - unfortunately - but why can't US insurance companies be less adversarial? Why can't they pay claims without going through all the games of denial - so that only the most persistent of people get reimbursed?

I am not afraid to talk to people who work for our new health insurance. In fact, the people I have dealt with are absolutely lovely. One woman has been trying different avenues to allow us to get the continuation - going out of her way to help us! I have never had that happen to me in the United States - in dealing with health insurers. I actually dread every time I have to speak with Cigna, because I know it will be stressful, and it usually means more of my time to "justify" to them why they should pay my claim.

I have been reading about Cigna, which includes Cigna forums online. Apparently, the morale at Cigna is at an all-time low. Several employees said they have to perform the jobs of 2 or more people. One person said their insurance benefits were poor. It doesn't seem surprising to me that employees would have low morale - for all the reasons stated and because they are encouraged to hang up their ethics before entering the place of work. How satisfying can it be to constantly say "no" to people - which possibly means going against their own better judgment or nature? The more you deny claims the more you advance in the organization... does this sound right, moral or good?

The Health Insurance industry in the US needs an overhaul. Perhaps they could learn something from Australian insurers?

CIGNA and Catch 22

There was only one catch and that was Catch-22, which specified that a concern for one's own safety in the face of dangers that were real and immediate was the process of a rational mind. Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Orr would be crazy to fly more missions and sane if he didn't, but if he was sane he had to fly them. If he flew them he was crazy and didn't have to; but if he didn't want to he was sane and had to. Yossarian was moved very deeply by the absolute simplicity of this clause of Catch-22 and let out a respectful whistle.

"That's some catch, that catch-22," he observed.

"It's the best there is," Doc Daneeka agreed.

CIGNA has its own Catch 22. Leaving aside a lot of extraneous, distracting, and basically irrelevant stuff, CIGNA's case against Judi is that it doesn't believe her doctor's statement that Judi is not able to work. The only way to prove that she can't work is to try to. If she tried to work and then got sick, she would have already lost her coverage by CIGNA anyway because she would no longer be eligible because she is working! It's as beautiful (and obscene) as Catch 22.

Tim

CIGNA and morality

Judi's post says a number of things that need to be said about her specific case. Driving back tonight, I was pondering how to communicate the true awfulness of CIGNA's actions in her case. CIGNA benefits from hiding in plain sight - there are so many cases of this sort that only the most egregious get the deserved attention from the media. I'd like all CIGNA case workers to act as though each case would be on the front page of the New York Times. It's a variant of the old adage that one should act as if the whole world is watching. I think CIGNA's actions in her case fail this test.

We are in the process of appealing (again).

Tim

U.S. INSURANCE COMPANIES SHOULD BE ASHAMED

I feel a need to talk about private (or company-sponsored) disability insurance. Disability insurance is something an individual signs up and pays for, with the understanding that if they become disabled, i.e., unable to work, then their insurance provider will pay a percentage of their salary at disability until they are able to work again. Most people depend upon this income, and the income they receive from SSDI (social security) to live.

I went on disability in the summer of 1998. Not working was incredibly difficult for me, because I enjoyed work and I derived self-esteem and a sense of identity from my job. It is obvious to Tim and I that I cannot work - my mental health won't allow for it. In past posts, I have discussed my MPD/DID and some of the symptoms I get. Some of my symptoms I prefer not to talk about here because they are of a more private and sensitive nature. However, some of my symptoms are consistent with most “mentally ill” people, e.g., difficulty concentrating, problems with interpersonal relationships, the inability to deal with various environmental stimulants (noise, talking, music, heat, crowds, etc.). With trauma survivors, there is also the chance of becoming triggered by an event or a person. When triggered, a person could have any type of originally adaptive, but possibly, negative response (e.g., crying, hiding, dissociating (spacing out), anger, hostility, etc.).

Since I was diagnosed in 1997, my life has changed. I had already suffered from depression, so I was used to the excessive sleeping and isolation. At one point, I tried to do too much and ended up in the hospital from a “breakdown” of sorts. What occurred is that one of my child alters attempted suicide by overdosing on prescription medicine (with a wine chaser). This might seem unbelievable to most readers of this blog, but I still have the note written in a child's hand saying “Judi go bye bye”. Even more strangely, I watched this event from somewhere up by my dining room's ceiling. Fortunately, I had helper parts of me who thought to call my psychiatrist, and an ambulance arrived at my door. I hardly remember the stomach pumping at the hospital, but I recall enough to know that I don't want to ever experience it again. As I write this, my mind darts to all the things that need more explanation, but I am not inclined to get into that much detail here.

Returning to the purpose of this entry, disability insurance in the United States is a huge and corrupt scam. I read an excellent article recently:

“Practices in Health care and Disability Insurance: Delay, Diminish, Deny, Blame”
by Peter Phillips and Bridget Thornton
(I can send you a pdf copy by email if you'd like to read this article.)

This article explains how the insurance industry has become so corrupt and why the disabled population - people who have the least energy or ability, but often the greatest need - are put through hell in attempts to get what is rightfully owed to them. Cigna Healthcare terminated my disability insurance benefits effective last summer. Since that time, Tim and I have been appealing their decision, currently working on a new appeal since the last appeal was denied. My doctor has stated that I am unable to work and why. Cigna, however, has chosen to follow the assessment of two doctors who do not know me, and are obviously quite ignorant about DID. Cigna is also basing most of its decision to terminate my insurance on this blog! For example, because they read that I was able to attend and enjoy an opera with Zoe and Tim, that I must be able to have sustained concentration over a period of time. An opera? I'd bet that any number of mental hospitals would love to have opera available to their patients to enjoy and relax with. So a three hour light opera proves that I am able to work - what are they thinking? This is just one small and silly example of their reasoning.... it goes on and on.

I heard that Cigna, among other insurance companies, was mentioned in Michael Moore's film, Sicko. Apparently, the staff who pay claims are awarded for how many claims they deny. The more claims denied, the better the advancement and compensation. I know this has to be true, because as a former HR professional and on behalf of employees, I had to fight Cigna on several occasions to get claims paid that should never have been denied in the first place. Now, since I have been sick, I have had to do the same for my own claims. I still haven't been paid for my last claim submissions, and it has been months. The last Explanation of Benefits I received was ridiculous. They denied most of my doctor visits because my provider's number was not listed (or something like that). Well, duhhhhhhhhhhhhhhhhh, she's here in Australia! Wouldn't you expect the international claims people to figure out that the provider numbers might be different in a country other than the US? I am certain that they just made up ridiculous reasons to deny my claims, hoping that I would get tired of fighting them. Unfortunately, that's what many people do. They give up and give in to the insurance companies - mostly because they are intimidated by insurance or rude and abusive claims people, or they are too sick or tired (or tired of caring for a sick loved one), to keep fighting.

Something has to change. I am tired of fighting, but I also can't give in because I really can't work now and I am entitled to the insurance payments.

I want to work. I like work. I would like the better income that work provides me.

Since Cigna has been monitoring this blog, they will probably say that what I have just written indicates my ability for sustained and coherent thought thereby proving that I am capable of maintaining employment. I never said I was stupid, I just told them that some days I can't go outside, talk to other people, or answer the telephone. Hmmmmm, why would that interfere with a job do you think?

Hopefully more ranting and raving to come....
Judi

Sad Kermit

Can a green frog sing the blues?

Sammy closeup

Sometimes it's hard to make out Sammy's face (or much of anything beyond a mass of black) in photos. Here's a nice closeup, taken at the Bayview leash free area.

Bertie and Hillary

This says it better than I ever could.

Help Impeach Darth Vader

Or even better, sign a petition to impeach Dick Cheney

A Gum Tree Fell Onto Our Neighbors House!

Really. We were in the way of a bad hailstorm last Sunday. Fortunately, our damage was minimal except for some dings on my car. In nearby suburbs, the hailstones were as big as cricket balls - ours were not quite that big.


The speck of blue in there is our very nice neighbor, David. (Pronounced with a spanish accent because he's from Chile.)

I say "our" damage, because "our" gigantic tree fell onto "our" neighbor's roof. As I speak, it is still resting on their roof and a huge branch of it is resting on our carport roof. The emergency services guys came to check it out after the storm and said they would have to get a crane to remove it. We sort of thought that might be done on Monday, but.... I guess there are a lot of big trees to move after that storm. Tim was at home when the tree fell, but didn't hear it. He said the wind and sound of the hail was so noisy that it was all he could hear. Our theory is that one particularly forceful gust of wind knocked over the tree at the base - no roots at all! It was growing among some large boulders, so I don't think the root system was at all extensive.



Cheers, Judi

My New Pasttime (read: Therapy)

I call these things Twigs. I invented them. Most of them are either hanging or standing earrings trees, the others are mobiles. The mobiles are best seen in motion because they spin and bobble and sparkle. I'm really enjoying making these things - it's relaxing and creative and all that good stuff. They are also natural - wood, willow, cane, collected sea shells and bird feathers.

As I am writing this a huge Yellow crested Cockatoo keeps trying to raid the bird feeder on the balcony. You try not to encourage these birds because if you later stop feeding them, they will destroy your house - no kidding! This particular cockatoo is quite persistent and I'm getting pissed off! So with luck I might have a whole new stash of large white feathers for my mobiles! (Just kidding. I couldn't hurt a fly.)

Cheers, Judi

Zappa and Vai - badly dressed great guitarists

Cranes flying over the Rio Grande

I'm in Socorro for a few days. Today the kids and I went down to the Rio Grande where I took these great pictures on my cell phone.


Cranes flying south over the Rio Grande

Doggy Heaven - where I used to take the dogs when we lived in Socorro

Zoe's first paper

Zoe is second author on a paper!

Gamma and beta neural activity evoked during a sensory gating paradigm: effects of auditory, somatosensory and cross-modal stimulation.

This was a result from her honors thesis.