Cigna Can Recover Payment for Unnecessary Bariatric Surgery

Cigna Healthcare Inc. may seek to recover from an insured the amount it paid for her medically unnecessary bariatric surgery, the Sixth Circuit said Monday.

Cigna was the administrator for Lisa Zahuranec’s employee benefit plan. Shortly after she began her employment, Zahuranec began investigating bariatric surgery.

Zahuranec asked Cigna multiple times to cover her surgery, but it refused. Although Zahuranec didn’t meet all the criteria in her benefit plan for medically necessary bariatric surgery, Cigna finally said her procedure would be covered.

Zahuranec developed complications from the surgery that were attributed to it not being medically necessary. She ultimately settled ...