Cigna PxDx Class Action Lawsuit 2026, Patients Seek Certification Over Millions of Alleged Automated Insurance Denials

Two Cigna health insurance policyholders are asking a California federal judge to certify nationwide and statewide classes covering millions of people whose medical claims were allegedly denied through an automated system called PxDx without meaningful review by a physician.

The October 30, 2026, class certification motion was filed in Kisting-Leung v. Cigna Corporation, a lawsuit pending since July 2023 in the U.S. District Court for the Eastern District of California.

Plaintiffs Michael Mahshigian and Randall Rentsch allege Cigna used its PxDx system to process large numbers of medical claims based on predetermined diagnosis and procedure codes, allowing medical directors to approve denials in seconds without examining individual medical records.

The proposed nationwide class could include more than 3 million people whose claims were allegedly denied through PxDx under employer-sponsored health plans governed by federal benefits law. A separate California class is estimated to cover approximately 1.4 million policyholders.

The plaintiffs want Cigna to stop the allegedly unlawful review process, reconsider affected claims and return money they contend the company improperly retained.

Cigna denies wrongdoing. The insurer maintains that PxDx is not artificial intelligence and that the system helps process claims for services already provided rather than preventing patients from receiving treatment.

The lawsuit remains pending. No class has been certified, and no court has determined that Cigna unlawfully denied the claims.

Cigna PxDx Class Action Lawsuit: Quick Facts

Detail	Latest information
Case	Kisting-Leung, et al. v. Cigna Corporation, et al.
Case number	2:23-cv-01477-DAD-CSK
Original filing	July 24, 2023
Latest major filing	October 30, 2026
Court	U.S. District Court, Eastern District of California
Judge	Dale A. Drozd
Defendants	Cigna Corporation (now The Cigna Group) and Cigna Health and Life Insurance Company
Class certification proponents	Michael Mahshigian and Randall Rentsch
Disputed system	PxDx, procedure-to-diagnosis review
Main allegation	Automated medical-necessity denials without meaningful individualized physician review
Nationwide class estimate	More than 3 million
California class estimate	Approximately 1.4 million
Main surviving legal theories	ERISA fiduciary-duty and California unfair-competition claims
Plaintiffs’ law firms	Clarkson Law Firm P.C.; Lockridge Grindal Nauen PLLC
Class certification	Requested, not granted
Reported hearing date	April 5, 2027 (per one report; confirm on docket)
Related case	Parallel action in Connecticut involving similar PxDx allegations
Settlement	None verified
Claim deadline	None

What Is Cigna’s PxDx System?

PxDx stands for procedure-to-diagnosis.

The system compares medical billing procedure codes with diagnosis codes to determine whether submitted services satisfy predetermined clinical coverage criteria.

Healthcare providers use standardized codes when submitting claims. A procedure code identifies the service provided, while a diagnosis code identifies the medical condition or reason for treatment.

According to the lawsuit, when a submitted diagnosis does not match Cigna’s approved criteria for a procedure, the PxDx process can identify the claim for denial.

The plaintiffs argue this substitutes standardized computer rules for the individualized clinical judgment that policyholders were promised.

Cigna’s health plans state, according to the plaintiffs, that a medical director will determine whether care is medically necessary through a thorough, fair and objective process.

How does the alleged denial process work?

The lawsuit describes a process involving:

1. A healthcare provider submits a medical claim.
2. PxDx compares the procedure and diagnosis codes against predetermined criteria.
3. Claims that do not match the criteria are identified for denial.
4. A Cigna medical director allegedly approves multiple denials together.
5. The patient or healthcare provider receives a denial stating that the treatment was not medically necessary.

The plaintiffs contend doctors sometimes signed off on batches of up to 50 denials without examining the patients’ medical records. Other descriptions of the allegations say directors reviewed hundreds or thousands of claims in a short period without opening individual patient files.

Cigna disputes that this process is unlawful and maintains that medical directors remain involved in reviewing the claims.

Did Cigna Really Deny 300,000 Claims in Two Months?

A March 2023 investigation by ProPublica and The Capitol Forum reported that Cigna medical directors denied more than 300,000 payment requests during a two-month period in 2022 using the PxDx process.

According to internal records reviewed by the journalists, the average review time was approximately 1.2 seconds per claim.

The plaintiffs rely on those findings to support their allegation that the reviews were not meaningfully individualized. The investigation helped spur the litigation.

The lawsuit also claims PxDx generated substantial savings by denying large volumes of relatively low-dollar claims.

However, the 300,000 figure is a historical investigative finding, not a court determination that all those denials were improper.

Likewise, the reported average review time does not establish that every individual denial violated the patient’s insurance policy.

Why Are Michael Mahshigian and Randall Rentsch Suing?

The two policyholders describe separate denied medical claims.

Michael Mahshigian: Anesthesia coverage denied

Mahshigian alleges Cigna used PxDx to deny anesthesia coverage twice for a procedure connected with treatment of chronic spinal pain.

He argues those decisions should have involved meaningful medical review.

His allegations are particularly important to the California subclass because he was added as a proposed representative following changes in the participation of an earlier plaintiff.

Randall Rentsch: Drug-testing claim denied

Rentsch alleges Cigna refused payment for a drug test required by his pain-management provider.

He claims the denial resulted from PxDx rather than a thorough medical evaluation of his circumstances.

Other original and amended plaintiffs have described similar automatic denials of claims they assert should have received individualized medical review.

The court must determine whether the claims are suitable for class-wide resolution and whether the plaintiffs can establish that the challenged process caused legally recognizable harm.

Related article: Gourmia Air Fryer Recall 2026, Nearly 176,000 Ovens Recalled After 40 Burn Injuries, Check Model GTF7530

Who Could Qualify for the Proposed Cigna Class Action?

The October 30 motion seeks certification of two groups.

Proposed group	Who may be included
Nationwide ERISA class	Members of qualifying ERISA-governed health plans whose claims Cigna allegedly denied through PxDx on or after January 1, 2011
California class	Members of qualifying group health plans administered by Cigna in California whose claims were allegedly denied through PxDx on or after July 24, 2019

The plaintiffs estimate more than 3 million potential nationwide members and approximately 1.4 million California members.

These figures do not establish the number of people legally eligible for relief, and the proposed classes could overlap. They should not be added together to claim 4.4 million separate people.

Does every Cigna member qualify?

No.

The lawsuit specifically concerns claims allegedly processed and denied through PxDx.

Having Cigna insurance, receiving a medical bill or experiencing a coverage denial does not automatically establish eligibility.

The type of insurance plan, claim-processing history, denial reason and relevant dates could all matter.

Can policyholders outside California qualify?

Potentially.

The proposed nationwide ERISA class includes qualifying policyholders outside California.

The separate California class concerns claims within the state’s proposed definition.

The fact that the case was filed in California does not limit the nationwide ERISA allegations to California residents.

Does the lawsuit cover Medicare Advantage?

The nationwide class is directed at ERISA-governed plans.

Medicare Advantage coverage is generally governed by a different federal regulatory framework and should not automatically be treated as included.

The proposed class definition and any future certification order will control.

Does the lawsuit cover individual or ACA marketplace plans?

Individual and marketplace plans are generally not governed by ERISA. The nationwide class targets ERISA plans, so people with individually purchased coverage should not assume they are included. The California class is described as covering members of group health plans administered by Cigna in California. Only the court’s final class definition will control.

What Does the October 30 Class Certification Motion Request?

The plaintiffs ask Judge Dale Drozd to find that their claims can be resolved collectively under Federal Rule of Civil Procedure 23.

They argue that class certification is appropriate because the alleged conduct resulted from a common PxDx claims-review process, and that common questions predominate: whether Cigna’s uniform use of PxDx breached plan terms, violated ERISA’s fiduciary standards, and, for California members, violated the state’s Unfair Competition Law.

The motion requests remedies including:

• An order preventing continued use of the allegedly unlawful denial process.
• Reprocessing of claims allegedly denied through PxDx.
• Restitution and other appropriate equitable relief.
• Recovery of benefits or financial gains allegedly retained through improper conduct, to the extent permitted by the surviving claims.

Class certification would not itself establish liability.

It would determine whether qualifying claims can proceed collectively rather than requiring every affected patient to litigate separately.

What must plaintiffs show to certify a class?

Rule 23(a) requires numerosity, commonality, typicality and adequate representation. A class seeking an injunction or declaratory relief must also satisfy Rule 23(b)(2), and a damages class must satisfy Rule 23(b)(3), which requires that common questions predominate and that a class is the superior way to resolve the dispute.

Defendants often rely on Wal-Mart Stores, Inc. v. Dukes, 564 U.S. 338 (2011), which requires common questions capable of class-wide resolution, and Comcast Corp. v. Behrend, 569 U.S. 27 (2013), which requires that damages theories match the liability theory. In the Ninth Circuit, plaintiffs must prove Rule 23’s requirements by a preponderance of the evidence (Olean Wholesale Grocery Cooperative, Inc. v. Bumble Bee Foods LLC, 31 F.4th 651 (9th Cir. 2022) (en banc)). A party who loses a certification ruling can ask the Ninth Circuit for permission to appeal under Rule 23(f).

What Happened in the March 2025 Court Ruling?

The case has already undergone an important legal narrowing.

On March 31, 2025, Judge Drozd granted part of Cigna’s motion to dismiss while allowing other claims to proceed.

The court dismissed the original ERISA benefits claim

The plaintiffs had asserted a claim under ERISA § 502(a)(1)(B) (29 U.S.C. § 1132(a)(1)(B)) seeking benefits allegedly owed under their insurance plans.

The judge concluded that they had not adequately identified the specific plan provisions establishing entitlement to the disputed benefits.

The court dismissed that claim with permission to amend.

The plaintiffs elected not to amend at that stage.

The ERISA fiduciary-duty claim survived in part

The court allowed certain plaintiffs to continue pursuing claims under ERISA § 502(a)(3) (29 U.S.C. § 1132(a)(3)).

This provision permits appropriate equitable relief for qualifying violations of ERISA or plan terms.

The plaintiffs allege Cigna breached fiduciary obligations by failing to provide the individualized medical review required by the plans.

California unfair-competition allegations also survived

The court permitted certain claims under California’s Unfair Competition Law to proceed.

It concluded that allegations involving California’s licensed-clinician-review requirements were sufficiently pleaded and that the relevant state-law theory was not expressly preempted by ERISA at that stage.

The ruling did not establish that Cigna actually violated those requirements.

It determined that specified claims could proceed beyond the dismissal stage.

Why Was Michael Mahshigian Added to the Case?

The latest motion follows another procedural development.

On September 30, 2026, the plaintiffs sought permission to amend the complaint to add Mahshigian as a representative of both proposed classes.

The filing explained that earlier plaintiff Samantha Dababneh had become unavailable to participate fully in the litigation because of personal circumstances.

The parties agreed to seek an amendment and additional discovery concerning the new proposed representative.

Cigna’s consent to the procedural request did not constitute an admission of wrongdoing.

The court’s subsequent docket includes the October 30 certification motion identifying Mahshigian and Rentsch.

The case continues under its original Kisting-Leung caption despite changes among the individual plaintiffs.

What Does Federal ERISA Law Require?

The Employee Retirement Income Security Act of 1974, commonly known as ERISA, governs many employer-sponsored health benefit plans.

Two provisions are particularly relevant.

29 U.S.C. § 1104(a)(1) establishes fiduciary obligations requiring plan fiduciaries to act prudently and in accordance with applicable duties owed to plan participants and beneficiaries.

29 U.S.C. § 1132(a)(3) permits eligible plaintiffs to seek appropriate equitable relief for certain ERISA or plan violations.

The key question is whether Cigna’s challenged conduct violated applicable fiduciary duties or the governing plan terms.

Can plaintiffs get money damages under ERISA?

Generally no. ERISA does not allow compensatory or punitive damages, and § 502(a)(3) relief is limited to “appropriate equitable relief.” The Supreme Court has held that a plaintiff can sue under § 502(a)(3) for fiduciary breaches that benefit only individuals, not just the plan (Varity Corp. v. Howe, 516 U.S. 489 (1996)), and that equitable remedies such as reformation, estoppel and surcharge may be available (CIGNA Corp. v. Amara, 563 U.S. 421 (2011)). That explains why the plaintiffs request reprocessing of claims, injunctive relief and restitution rather than ordinary damages. Prevailing parties may also seek attorneys’ fees under ERISA § 502(g) (29 U.S.C. § 1132(g)(1)).

What do the federal claims regulations require?

Federal regulations also require qualifying group health plans to provide a full and fair review of adverse benefit determinations.

Under 29 C.F.R. § 2560.503-1, an appeal involving medical judgment generally requires consultation with an appropriately trained healthcare professional who was not responsible for the initial determination.

The regulation’s requirements for appeals should not be confused with a universal rule that every initial claims-processing task must be performed manually by a physician.

The Affordable Care Act adds internal appeal and external review rights for many plans (42 U.S.C. § 300gg-19; 45 C.F.R. § 147.136).

What California Law Applies?

The California class relies partly on Health and Safety Code § 1367.01(e).

The provision generally requires that medical-necessity decisions denying or modifying requests for authorization of healthcare services be made by an appropriately licensed and competent physician or healthcare professional.

The plaintiffs argue that Cigna violated this requirement by substituting PxDx’s automated process for meaningful medical judgment.

They invoke Business and Professions Code § 17200, California’s Unfair Competition Law, as a basis for challenging the alleged practice.

Cigna maintains that licensed medical directors participate in the decision process.

The distinction between automated assistance and automated medical decision-making is central to the dispute.

California has also addressed automated tools in utilization review. A 2024 law, SB 1120 (the “Physicians Make Decisions Act”), amended the Health and Safety Code to require that medical-necessity decisions be made by licensed health professionals and that artificial intelligence or algorithms not replace that judgment. That law took effect after the period at the center of the lawsuit and is not a basis for the claims here, but it shows the direction of state regulation. California’s Department of Managed Health Care also oversees health plans under the Knox-Keene Act (Health & Safety Code § 1340 et seq.) and runs an independent medical review process for denied care (Health & Safety Code § 1374.30 et seq.).

Can ERISA Preempt the California Claims?

This is a major legal fight in cases like this. ERISA preempts state laws that “relate to” employee benefit plans (29 U.S.C. § 1144(a)), but it saves state laws that regulate insurance (§ 1144(b)(2)(A)). The Supreme Court has also held that state-law claims that duplicate or supplement ERISA’s exclusive remedies are preempted (Aetna Health Inc. v. Davila, 542 U.S. 200 (2004); Pilot Life Insurance Co. v. Dedeaux, 481 U.S. 41 (1987)), while upholding certain state insurance regulations such as independent-review laws (Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002); Kentucky Association of Health Plans, Inc. v. Miller, 538 U.S. 329 (2003)).

Judge Drozd found in March 2025 that the California theory was not expressly preempted at the dismissal stage. Cigna can still raise preemption again later.

Must Patients Appeal First Before Suing Under ERISA?

In many circuits, including the Ninth, ERISA claimants generally must exhaust the plan’s internal appeal process before filing a benefits lawsuit, unless an exception applies such as futility (Vaught v. Scottsdale Healthcare Corp. Health Plan, 546 F.3d 620 (9th Cir. 2008)). Exhaustion can become an issue for class members, because their claims may involve different appeal histories. This is one reason an individual who disagrees with a denial should use the appeal process rather than rely on the class case.

Is PxDx Artificial Intelligence?

Cigna disputes descriptions of PxDx as an artificial intelligence system.

The company has characterized it as a process using established clinical coverage criteria to match procedure and diagnosis codes.

The plaintiffs characterize the technology as an automated algorithm that allows denials without meaningful human review.

An algorithm does not necessarily use machine learning or generative AI.

The central legal question is therefore not whether the software qualifies as AI under a particular technical definition.

It is whether claims were reviewed and denied in a manner consistent with the insurance plans and applicable law.

Insurers more broadly have argued that technology-assisted review can improve consistency and efficiency while still satisfying legal requirements when properly overseen by licensed physicians. The PxDx case is part of a wider wave of scrutiny of insurers’ use of automated or algorithmic tools in claims decisions.

How Has Cigna Responded?

Cigna has denied the plaintiffs’ allegations.

A company spokesperson told Law360 that PxDx does not use artificial intelligence and that the process does not prevent care because it concerns claims reviewed after treatment has occurred.

Cigna has also maintained that the process allows medical directors to apply clinical coverage policies and that its review procedures comply with applicable law and plan terms.

The insurer may challenge class certification on grounds involving individualized claim circumstances, plan differences, the proposed representatives or the availability of class-wide remedies.

Cigna’s formal opposition to the certification motion had not been identified in public reporting as of November 11, 2026.

No final determination resolving those issues has been made.

Can Cigna Patients Receive Compensation?

Not currently through this lawsuit.

The plaintiffs seek relief that could include reprocessing allegedly improper denials and recovery of certain financial losses or gains.

However, no settlement fund, payout schedule or approved claims process exists.

Even if a class is certified, the plaintiffs must still establish liability and an appropriate remedy.

If a settlement is later reached, Rule 23(e) requires court approval after notice to class members and a fairness hearing.

The case should not be confused with an insurance settlement where consumers can immediately submit a claim.

Be cautious of websites or messages that offer to file a “claim” in this case or ask for payment or personal financial details. No official claims process exists.

For comparison, $3.6M Anthem Proton Beam Cancer Treatment Settlement, Check If You Qualify for a Payment, Taylor, et al. v. Anthem Insurance Companies Inc., et al., Case No. 3:23-cv-00541 concerns a separate ERISA dispute over medical treatment coverage that reached a proposed settlement.

What Should Cigna Members Do if Their Medical Claims Were Denied?

Consumers who believe their claims were denied improperly can review their insurance documents and consider an appeal.

Useful records include the explanation of benefits, claim denial letters, plan documents, medical records, physician recommendations, appeal correspondence and any bills paid after the denial.

For ERISA-governed group health plans, federal regulations generally require at least 180 days after receiving an adverse benefit determination to submit an internal appeal.

Different rules can apply to other insurance arrangements and urgent claims.

Patients should not wait for the PxDx class action to resolve before addressing an individual medical claim.

California members of state-regulated plans can also ask the Department of Managed Health Care about an independent medical review, and many plans offer external review under the Affordable Care Act. Members can also ask their employer’s benefits department for the plan documents.

For another dispute involving ERISA coverage representations, see Delta Dental Class Action Claims Company Misrepresents Out-of-Network Coverage—What Policyholders Need to Know.

For general information about disputing an insurer’s denial, see Insurance Company Denied Your Injury Claim, Here Are Your Legal Rights and Exactly What to Do Next. That guide concerns personal-injury insurance claims, whose procedures can differ from ERISA health-plan appeals.

Cigna PxDx Lawsuit Timeline

Date	Development
March 2023	ProPublica publishes investigation into Cigna’s PxDx denials
July 24, 2023	Original lawsuit filed
June 14, 2024	Third amended complaint filed
March 31, 2025	Judge dismisses some claims but allows fiduciary-duty and California unfair-competition theories to proceed
May 2, 2025	Cigna files answer
August 13, 2026	Plaintiff Abdulhussein Abbas dismissed by stipulation
September 30, 2026	Plaintiffs seek amendment adding Michael Mahshigian
October 20, 2026	Judge permits expanded class-certification briefing
October 30, 2026	Plaintiffs file motion seeking nationwide and California class certification
October 30, 2026	Court issues order governing confidential certification materials
November 5, 2026	Additional procedural docket activity recorded
November 10, 2026	Latest certification request receives wider news coverage
November 12, 2026	Deadline for Cigna’s sealing request under October 30 order
April 5, 2027	Class-certification hearing reportedly scheduled (confirm on docket)

The publicly available scheduling materials also reference later discovery and motion deadlines in 2027. Those dates may change through subsequent court orders.

Who Represents the Plaintiffs?

The plaintiffs are represented by Glenn A. Danas, Shireen M. Clarkson, Zarrina Ozari, Adrian J. Barrio, Michael A. Boelter, Derek Brandt, Grace I. Chanin and Larkin Turner of Clarkson Law Firm P.C., and by Karen Hanson Riebel, David W. Asp, Simeon A. Morbey, Derek C. Waller, Emma Ritter Gordon and Margaret Eve Grabau of Lockridge Grindal Nauen PLLC.

Frequently Asked Questions

What is the Cigna PxDx class action lawsuit about?

The plaintiffs allege Cigna used an automated procedure-to-diagnosis review process to deny medical claims without meaningful individualized physician review, potentially violating ERISA and California law.

Who filed the latest class certification motion?

Michael Mahshigian and Randall Rentsch, according to the October 30, 2026 filing.

Who is the judge?

U.S. District Judge Dale A. Drozd of the Eastern District of California.

How many people could be affected?

The plaintiffs estimate more than 3 million people in the nationwide proposed class and about 1.4 million in the California class. The figures are not certified class counts and may overlap.

Does every Cigna policyholder qualify?

No. The proposed classes concern qualifying claims allegedly denied through PxDx during specified periods.

Was Cigna found guilty of denying claims illegally?

No. This is civil litigation, and there has been no finding of liability in the case.

Is PxDx an AI system?

The plaintiffs describe an automated algorithm. Cigna says the process does not use artificial intelligence.

Can people outside California participate?

Potentially, if they meet the proposed nationwide ERISA class definition and a court ultimately certifies it.

Was the Cigna lawsuit dismissed?

Only in part. The March 2025 ruling dismissed some claims and plaintiffs but allowed specified ERISA fiduciary-duty and California unfair-competition claims to continue.

Has the judge certified the classes?

No. The plaintiffs filed their certification request on October 30, and no granting order was verified as of November 11.

When is the class certification hearing?

One report lists April 5, 2027. Check the docket for the current date, because scheduling orders can change.

Will Cigna reprocess denied claims?

That is relief the plaintiffs are requesting. No final court order requiring class-wide reprocessing was verified.

Is there a Cigna PxDx settlement?

No. No settlement or compensation fund has been announced for this case.

Is there a related case in another court?

Reporting says the parties have coordinated with a parallel action in Connecticut involving similar PxDx allegations.

How can I tell whether PxDx was involved in my denial?

Review the denial notice and request relevant claims-processing information through the plan’s applicable procedures. Not every Cigna denial necessarily involved PxDx, and the precise internal review method may not be obvious from an explanation of benefits.

Can I sue Cigna on my own over a denied claim?

Possibly, but ERISA plan members generally must first use the plan’s appeal process, and remedies under ERISA are limited. A benefits or insurance attorney can review your plan type and deadlines.

What Happens Next?

The next major stage is class certification briefing.

Cigna will have an opportunity to oppose the proposed class definitions and the plaintiffs’ arguments for collective treatment.

Judge Drozd must then determine whether the case meets the requirements of Federal Rule of Civil Procedure 23.

That decision could significantly affect the scope of the litigation.

If the classes are certified, the lawsuit could move toward summary-judgment briefing, further discovery on class-wide liability or remedies, and possibly trial or settlement discussions. If certification is denied, the remaining individual claims may still proceed, subject to further court rulings.

Class certification is often the pivotal stage in large insurance and ERISA actions, because it determines whether the claims of millions of members can be resolved together rather than through individual lawsuits.

No final certification decision, liability judgment or settlement has been verified.

The Bottom Line

The October 30 class certification motion represents an important step in the three-year legal dispute over Cigna’s PxDx claims-review process.

The plaintiffs allege that Cigna improperly relied on automated diagnosis and procedure matching while medical directors approved denials without meaningful individualized review.

They want the court to certify classes potentially covering millions of policyholders and require Cigna to address claims allegedly denied through the challenged process.

Cigna disputes the allegations and maintains that its review process involves medical professionals.

For policyholders, the central issue is whether insurance companies can rely on automated systems when deciding medical necessity without providing the individualized professional review required by their plans and applicable law.

The answer in this case remains for the court to determine.

Laws, Rules and Cases Referenced in This Article

Authority	What it covers
29 U.S.C. § 1104(a)(1)	ERISA fiduciary duties
29 U.S.C. § 1132(a)(1)(B), (a)(3), (g)(1)	ERISA benefits claims; equitable relief; attorneys’ fees
29 U.S.C. § 1144(a), (b)(2)(A)	ERISA preemption and insurance savings clause
29 C.F.R. § 2560.503-1	ERISA claims and appeals procedure
42 U.S.C. § 300gg-19; 45 C.F.R. § 147.136	ACA internal appeals and external review
Cal. Health & Safety Code § 1367.01(e)	Licensed review of medical-necessity denials
Cal. Health & Safety Code § 1340 et seq.; § 1374.30 et seq.	Knox-Keene Act; independent medical review
Cal. SB 1120 (2024)	Physician decision-making; limits on AI in utilization review
Cal. Bus. & Prof. Code § 17200	Unfair Competition Law
Fed. R. Civ. P. 23(a), (b)(2), (b)(3), (e), (f)	Class certification, settlement approval, appeal
Varity Corp. v. Howe, 516 U.S. 489 (1996)	Individual relief for fiduciary breach under § 502(a)(3)
CIGNA Corp. v. Amara, 563 U.S. 421 (2011)	Equitable remedies under ERISA
Aetna Health Inc. v. Davila, 542 U.S. 200 (2004); Pilot Life v. Dedeaux, 481 U.S. 41 (1987)	ERISA preemption of state-law claims
Rush Prudential v. Moran, 536 U.S. 355 (2002); Kentucky Ass’n of Health Plans v. Miller, 538 U.S. 329 (2003)	State insurance laws saved from preemption
Wal-Mart Stores v. Dukes, 564 U.S. 338 (2011); Comcast v. Behrend, 569 U.S. 27 (2013)	Commonality and damages models in class actions
Olean Wholesale Grocery Coop. v. Bumble Bee Foods, 31 F.4th 651 (9th Cir. 2022)	Ninth Circuit Rule 23 proof standard
Vaught v. Scottsdale Healthcare Corp. Health Plan, 546 F.3d 620 (9th Cir. 2008)	ERISA exhaustion requirement

Primary Court Records and Sources

1. Kisting-Leung v. Cigna — Georgetown Law Health Care Litigation Tracker — Case history and October 30, 2026 class certification filing.
2. Plaintiffs’ October 30, 2026 Motion for Class Certification (PDF) — Primary filing requesting certification.
3. March 31, 2025 Federal Court Order (PDF) — Judge Drozd’s ruling on surviving and dismissed claims.
4. September 30, 2026 Motion to Add Michael Mahshigian (PDF) — Proposed plaintiff amendment.
5. October 30, 2026 Scheduling Order (PDF) — Confidential filing procedures and November 12 deadline.
6. ProPublica — How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them — March 2023 investigation.
7. Top Class Actions — Cigna Lawsuit Seeks Class Certifications Over PxDx Insurance Denials — November 10, 2026 reporting.
8. U.S. Department of Labor — Group Health Plan Claims Procedure Requirements.
9. California Health and Safety Code § 1367.01.
10. Federal Rule of Civil Procedure 23.

Researched and written by Israr Ahmad, legal content researcher and founder of AllAboutLawyer.com. All facts verified against the court filings and orders in Kisting-Leung v. Cigna Corporation, No. 2:23-cv-01477 (E.D. Cal.), including the October 30, 2026 class certification motion and the March 31, 2025 order, the ProPublica investigation, and the cited federal and California law, as of November 11, 2026. Last Updated: November 11, 2026.

Verification note: The October 30 filing and its requested classes were confirmed through court docket information and contemporaneous reporting. The complete, heavily redacted certification-motion package and supporting exhibits were not independently reviewed in full. Proposed class sizes and financial savings are plaintiffs’ claims, not judicial findings.

This article is for informational purposes only and does not constitute legal or medical advice. Laws vary by state and individual circumstances differ. For advice about your specific situation, consult a qualified attorney or healthcare provider. AllAboutLawyer.com is an independent legal-information website, not a law firm. The plaintiffs’ allegations remain unproven, and the court has not determined Cigna’s liability.