CXL paid for WPA medical insurance

[sushila]

Hi ,
Latest from Cigna below.They are still refusing to pay since they claim it lacks robust evidence. I am thinking of pursuing this further using Chris's advice in previous postings and asking for "letter of deadlock" and taking this to Ombudsman. Has anyone had experience of taking this matter to Ombusdam and being sucessful? Thanks, Sushila

Our Nurse Manager has looked into your query below, and she has confirmed that as the treatment is not covered as it still lacks robust evidence for use. As you are aware, we require treatment to be evidence based before we can authorise. We have had it recently re-checked by our Medical Advisory Panel and there is still no change to our stance – therefore the claim must remain as denied.

I can confirm the reason the procedure is covered “postcode lottery” via the NHS is due to the fact it’s not evidence based, and only sporadic units will be doing this via research and audit.

I’m sorry that the treatment is outside of our Terms and Conditions, and I understand that you will be disappointed by our decision, but at present we are unable to cover the treatment.