Complaints procedures

Cigna Insurance Saudi Arabia as a company aims to resolve all complaints fairly, consistently and promptly. If any of our members or policyholders have cause to complain we will seek to deal with concerns raised as effectively and quickly as possible.

Definition of a complaint

Any expression of dissatisfaction by a customer, potential customer or other business partner or any regulatory body made to the company either directly or indirectly which is related to a product or service provided by the company or which is related to an employee of the company or which is related to a service provided by an intermediary acting on behalf of the company or provided by another business partner of the company such as but not limited to a health claims management company, hospital, clinic or physician.

What is not a complaint?

Any expression of dissatisfaction concerning denial of coverage for a consultation, treatment or procedure which is clearly not covered under the policy or where the cost of the treatment exceeds the monetary limits under the terms of the policy are not complaints. However, where the cause of the complaint relates wholly or in part to vague wording or unclear definitions in the policy wording, terms and conditions or table of benefits this will be considered a complaint.

These are the steps which we follow in our complaints handling process:

1. Follow the above definition of a complaint.
2. Call our toll-free number: 800 1000 244.
3. Or submit your complaint to ComplaintsMena@Cigna.com. (Your email should contain all the supporting information relating to the complaint.)

Complaint acknowledgement

We endeavour to acknowledge your complaint by return, the complaint will be logged within 2 business days and the initial response will be sent to the members/providers at the registered email. In the acknowledgement letter we may ask you for further clarification of your complaint and other information.

Complaint investigation

Any complaints made are investigated by trained and competent complaint handling staff. During our investigation we will be as thorough as possible, and may also contact you by telephone for any additional information to allow us to complete the investigation as quickly as possible.

Complaint resolution

The complaint handling staff will review the information gathered in the investigation, review the facts and take full account of these when reaching a conclusion. We will seek to do this with as little delay as possible, however to conclude a thorough investigation it may take some time, depending on the complexity of the concerns raised. If the complaint handler is unable to give a full reply within 24 hours from the receipt of your complaint, we will write to you in order to keep you informed of the investigations progress. If the complaint handler is still unable to resolve your complaint after a further 48 hours we will again write to you concerning the progress of the investigation. Please note that the total complaints Turnaround Time (TAT) is 5 working days.

Informing you of our decision

Once the investigation is completed the complaint handler will write to you with a full account of our investigation and the decision. Whether our decision is to agree that your complaint is justified, or to state that we feel your concerns are unfounded, we will set it out so that you will be able to see that the decision is fair and reasoned based on the information gathered.

Please click here [PDF] to download the complaints form.