Cigna Healthcare of North Carolina will pay a $600,000 fine and customer refunds and credits totalling $637,974.98 in a settlement with North Carolina Insurance Commissioner Wayne Goodwin, The Triangle (North Carolina) Business Journal reports.
Cigna has major claims operations in Bloomfield.
The settlement arose out of a routine Department of Insurance, DOI, market exam of the company that began in 2005 and looked at the years 2002-04.
DOI says its examiners found a variety of violations including “widespread failure to maintain adequate records,” and “failure to accurately and consistently calculate premium rates in accordance with (approved) rating methodology …”
In addition, DOI says, the firm wasn’t processing claims in a timely fashion and was failing to send acknowledgment letters within three business days for member grievances …”
DOI says refunds were issued last August.
