`Case 1:21-cv-02671 Document 1-1 Filed 05/12/21 Page 1 of 6 PageID #: 6
`
`EXHIBIT 1
`
`EXHIBIT 1
`
`
`
`INDEX NO. 508684/2021
`FILED: KINGS COUNTY CLERK 04/13/2021 04:07 PM
`Case 1:21-cv-02671 Document 1-1 Filed 05/12/21 Page 2 of 6 PageID #: 7
`NYSCEF DOC. NO. 2
`RECEIVED NYSCEF: 04/13/2021
`
`SUPREME
`KINGS
`
`COURT
`COUNTY
`
`OF THE STATE
`
`OF NEW YORK
`
`MANAGEMENT
`ENIGMA
`CORP.,
`ALLIANCE
`LABORATORIES,
`d/b/a
`
`Index
`
`No.:
`
`Plaintiff,
`
`-against-
`
`COMPLAINT
`
`CIGNA
`CIGNA
`CIGNA
`
`HEALTH
`MANAGEMENT,
`HEALTHCARE,
`INC.,
`HOLDING
`COMPANY,
`
`INC.,
`
`and
`
`-------------------------------
`
`Defendants.
`-------------------------x
`
`Plaintiff,
`
`Enigma
`
`Management
`
`Corp.,
`
`a/k/a
`
`Alliance
`
`Laboratory,
`
`by
`
`its attorneys,
`
`The
`
`Law Office
`
`of Roman
`
`Popik,
`
`P.C.,
`
`alleges
`
`as and
`
`for
`
`its Complaint
`
`against
`
`Defendants,
`
`CIGNA
`
`Health
`
`Management
`
`Inc., CIGNA
`
`Healthcare
`
`Inc.,
`
`and CIGNA
`
`Holding
`
`Company
`
`as follows:
`
`JURISDICTION
`
`1.
`
`This
`
`Court
`
`has personal
`
`jurisdiction
`
`over
`
`Defendants
`
`because
`
`they
`
`transact
`
`business
`
`within
`
`the State
`
`of New York.
`
`2.
`
`Court
`
`has
`
`subject
`
`matter
`
`jurisdiction
`
`over
`
`this
`
`action
`
`because
`
`the
`
`causes
`
`of action
`
`This
`
`asserted
`
`by Plaintiff
`
`arise
`
`under
`
`common
`
`law and
`
`the
`
`laws
`
`of
`
`the State
`
`of New York.
`
`3.
`
`Pursuant
`
`to CPLR
`
`503(a),
`
`venue
`
`is proper
`
`in this Court
`
`because
`
`Plaintiff's
`
`principal
`
`place
`
`of business
`
`is located
`
`in Kings
`
`County.
`
`PARTIES
`
`4.
`
`or
`
`Plaintiff,
`
`Enigma
`
`Management
`
`Corp.,
`
`a/k/a
`
`Alliance
`
`Laboratory
`
`(hereinafter
`
`"Plaintiff"
`
`"ALLIANCE"),
`
`was
`
`and
`
`continues
`
`to be
`
`a New York
`
`corporation
`
`with
`
`its
`
`principal
`
`place
`
`of
`
`business
`
`located
`
`at 3611
`
`14th
`
`Avenue,
`
`Brooklyn,
`
`New York
`
`11218.
`
`5.
`
`ALLIANCE
`
`is a state-of-the-art
`
`clinical
`
`laboratory
`
`facility
`
`providing
`
`a wide
`
`variety
`
`of
`
`services
`
`to the New York
`
`Metropolitan
`
`area.
`
`1 of 5
`
`
`
`INDEX NO. 508684/2021
`FILED: KINGS COUNTY CLERK 04/13/2021 04:07 PM
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`NYSCEF DOC. NO. 2
`RECEIVED NYSCEF: 04/13/2021
`
`6.
`
`Upon
`
`information
`
`and
`
`belief,
`
`Defendant,
`
`CIGNA
`
`Health
`
`Management,
`
`Inc.,
`
`("CIGNA
`
`Management")
`
`was
`
`and
`
`continues
`
`to be a Delaware
`
`corporation
`
`authorized
`
`to conduct
`
`business
`
`in the State
`
`of New York.
`
`7.
`
`Upon
`
`information
`
`and
`
`belief,
`
`Defendant,
`
`CIGNA
`
`Healthcare,
`
`Inc.,
`
`("CIGNA
`
`Healthcare")
`
`was
`
`and
`
`continues
`
`to be a Vermont
`
`corporation
`
`authorized
`
`to conduct
`
`business
`
`in
`
`the State
`
`of New York.
`
`8.
`
`Upon
`
`information
`
`and
`
`belief,
`
`Defendant,
`
`CIGNA
`
`Holding
`
`Company
`
`("CIGNA
`
`Holding")
`
`and
`
`continues
`
`to be a Delaware
`
`corporation
`
`authorized
`
`to conduct
`
`business
`
`in the State
`
`of
`
`was
`
`New York.
`
`9.
`
`Upon
`
`information
`
`and
`
`belief,
`
`CIGNA
`
`Management
`
`and
`
`CIGNA
`
`Healthcare
`
`are
`
`subsidiaries
`
`of CIGNA
`
`Holding
`
`(hereinafter
`
`all
`
`Defendants
`
`are
`
`collectively
`
`referred
`
`to
`
`as
`
`"CIGNA").
`
`10.
`
`Upon
`
`information
`
`and
`
`belief,
`
`CIGNA
`
`is a global
`
`health
`
`insurance
`
`company,
`
`which,
`
`in
`
`part,
`
`issues
`
`group
`
`and
`
`individual
`
`medical
`
`insurance
`
`coverage.
`
`GENERAL
`
`BACKGROUND
`
`11.
`
`On January
`
`31,
`
`2020,
`
`HHS
`
`Secretary
`
`Alex
`
`M. Azar
`
`declared
`
`that
`
`as of
`
`January
`
`27,
`
`2020,
`
`2019
`
`novel
`
`coronavirus.
`
`a public
`
`health
`
`emergency
`
`exists
`
`nationwide
`
`as a result
`
`of
`
`the
`
`12.
`
`On March
`
`18, 2020,
`
`President
`
`Trump
`
`signed
`
`into
`
`law Families
`
`First
`
`Coronavirus
`
`Response
`
`Act
`
`("FFCRA").
`
`13.
`
`Section
`
`6001
`
`of
`
`the FFCRA
`
`generally
`
`requires
`
`health
`
`insurance
`
`issuers
`
`offering
`
`individual
`
`health
`
`insurance
`
`coverage
`
`to provide
`
`benefits
`
`for
`
`certain
`
`items
`
`and
`
`services
`
`related
`
`to
`
`testing
`
`March
`
`for
`
`the
`
`detection
`
`of COVID-19
`
`when
`
`those
`
`items
`
`or services
`
`were
`
`furnished
`
`on or after
`
`18, 2020.
`
`must
`
`provide
`
`this
`
`coverage
`
`without
`
`cost-
`
`14.
`
`Under
`
`the FFCRA,
`
`issuers
`
`imposing
`
`any
`
`sharing
`
`requirements,
`
`prior
`
`authorization
`
`or other medical
`
`management
`
`requirements.
`
`AS AND FOR A FIRST
`B_REACH
`
`OF ACTION
`CAUSE
`OF CONTRACT
`
`FOR
`
`15.
`
`Plaintiff
`
`repeats,
`
`reiterates
`
`and
`
`realleges
`
`each
`
`and
`
`every
`
`allegation
`
`contained
`
`in
`
`paragraphs
`
`1 through
`
`14 with
`
`the
`
`same
`
`force
`
`and
`
`effect
`
`as if set
`
`forth
`
`at
`
`length
`
`herein.
`
`16.
`
`Commencing
`
`after
`
`March
`
`18,
`
`2020,
`
`ALLIANCE
`
`received
`
`hundreds
`
`of
`
`specimens
`
`obtained
`
`from
`
`the
`
`individuals
`
`by
`
`different
`
`medical
`
`providers
`
`for COVID-19
`
`testing.
`
`-2-
`
`2 of 5
`
`
`
`INDEX NO. 508684/2021
`FILED: KINGS COUNTY CLERK 04/13/2021 04:07 PM
`Case 1:21-cv-02671 Document 1-1 Filed 05/12/21 Page 4 of 6 PageID #: 9
`NYSCEF DOC. NO. 2
`RECEIVED NYSCEF: 04/13/2021
`
`17.
`
`At
`
`all
`
`relevant
`
`times,
`
`all
`
`COVID-19
`
`specimen
`
`sent
`
`to ALLIANCE
`
`for
`
`testing
`
`were
`
`accompanied
`
`requisition
`
`by
`
`forms
`
`filled
`
`out
`
`by medical
`
`providers.
`
`18.
`
`Upon
`
`information
`
`and
`
`belief,
`
`all
`
`requisition
`
`forms
`
`from
`
`medical
`
`providers
`
`to ALLIANCE
`
`provided
`
`CIGNA
`
`as the
`
`insurance
`
`carrier
`
`for
`
`each COVID-19
`
`tested
`
`individual.
`
`19.
`
`Upon
`
`information
`
`and
`
`belief,
`
`each
`
`COVID-19
`
`tested
`
`individual
`
`had
`
`contractual
`
`relationship
`
`with
`
`CIGNA.
`
`20.
`
`The
`
`contractual
`
`relationship
`
`between
`
`each
`
`individual,
`
`who
`
`was
`
`tested
`
`for COVID-19,
`
`and
`
`CIGNA
`
`was
`
`valid
`
`and
`
`binding.
`
`COVID-19
`
`and CIGNA
`
`21.
`
`The
`
`contractual
`
`relationship
`
`between
`
`each
`
`individual
`
`tested
`
`for
`
`intended
`
`to benefit
`
`ALLIANCE,
`
`which
`
`provided
`
`services
`
`arising
`
`out
`
`of
`
`such
`
`testing.
`
`22.
`
`The
`
`benefit
`
`of
`
`the
`
`contractual
`
`relationship
`
`between
`
`each COVID-19
`
`tested
`
`individual
`
`and
`
`CIGNA
`
`to ALLIANCE
`
`was
`
`direct
`
`and
`
`sufficiently
`
`immediate.
`
`23.
`
`At
`
`all
`
`relevant
`
`times,
`
`ALLIANCE
`
`was
`
`and
`
`still
`
`is
`
`a third-party
`
`beneficiary
`
`of
`
`the
`
`contractual
`
`relationship
`
`between
`
`insured
`
`COVID-19
`
`tested
`
`individuals
`
`and CIGNA.
`
`24.
`
`After
`
`ALLIANCE
`
`conducted
`
`COVID-19
`
`tests,
`
`it
`
`submitted
`
`claims
`
`for
`
`services
`
`to
`
`CIGNA.
`
`of
`
`25.
`
`At
`
`all
`
`relevant
`
`times,
`
`CIGNA
`
`acknowledged
`
`receipt
`
`of
`
`claims,
`
`but
`
`demanded
`
`"a
`
`copy
`
`this
`
`patient
`
`complete
`
`medical
`
`record,
`
`including
`
`billing
`
`ledgers
`
`and
`
`intake
`
`or
`
`registration
`
`forms".
`
`26.
`
`Since
`
`ALLIANCE
`
`never
`
`had
`
`possession
`
`of
`
`patients'
`
`complete
`
`medical
`
`records
`
`nor
`
`did
`
`it
`
`have
`
`an authority
`
`to disclose
`
`such
`
`records
`
`to CIGNA,
`
`ALLIANCE
`
`could
`
`only
`
`provide
`
`complete
`
`summaries
`
`of
`
`tests
`
`conducted
`
`for
`
`each
`
`individual
`
`specimen.
`
`27.
`
`At
`
`all
`
`relevant
`
`times,
`
`ALLIANCE
`
`did
`
`not
`
`have
`
`contact
`
`with
`
`any
`
`patients
`
`whose
`
`specimen
`
`for COVID-19.
`
`were
`
`tested
`
`28.
`
`ALLIANCE's
`
`performance
`
`was
`
`appropriate
`
`to effectuate
`
`the
`
`intentions
`
`of each
`
`COVID-
`
`19 tested
`
`individual
`
`and CIGNA.
`
`29.
`
`CIGNA
`
`did
`
`not
`
`pay ALLIANCE
`
`for
`
`the
`
`services
`
`provided
`
`under
`
`FFCRA
`
`and/or
`
`contractual
`
`relationship
`
`with
`
`COVID-19
`
`tested
`
`individuals
`
`who
`
`had
`
`insurance
`
`policies
`
`issued
`
`by
`
`CIGNA.
`
`30.
`
`At
`
`all
`
`relevant
`
`times,
`
`CIGNA's
`
`actions
`
`or omissions
`
`to act, which
`
`were
`
`stated
`
`above,
`
`constitute
`
`multiple
`
`breaches
`
`of
`
`their
`
`obligations
`
`under
`
`FFCRA
`
`and/or
`
`contractual
`
`relationship
`
`with
`
`COVID-19
`
`tested
`
`individuals,
`
`who
`
`had
`
`insurance
`
`policies
`
`issued
`
`by CIGNA.
`
`-3-
`
`3 of 5
`
`
`
`INDEX NO. 508684/2021
`FILED: KINGS COUNTY CLERK 04/13/2021 04:07 PM
`Case 1:21-cv-02671 Document 1-1 Filed 05/12/21 Page 5 of 6 PageID #: 10
`NYSCEF DOC. NO. 2
`RECEIVED NYSCEF: 04/13/2021
`
`31.
`
`As
`
`a result
`
`of
`
`the
`
`foregoing,
`
`ALLIANCE
`
`is entitled
`
`to money
`
`judgment
`
`of not
`
`less
`
`than
`
`$300,000,
`attorneys'
`
`the
`
`exact
`
`amount
`
`to be determined
`
`at
`
`trial,
`
`plus
`
`interest
`
`from
`
`March
`
`18, 2020
`
`and
`
`fees.
`
`AS AND FOR A SECOND
`CAUSE
`ENRICHMENT
`UNJUST
`
`OF ACTION
`
`FOR
`
`32.
`
`Plaintiff
`
`repeats,
`
`reiterates
`
`and
`
`realleges
`
`each
`
`and
`
`every
`
`allegation
`
`contained
`
`in
`
`paragraphs
`
`1 through
`
`31 with
`
`the
`
`same
`
`force
`
`and
`
`effect
`
`as if set
`
`forth
`
`at
`
`length
`
`herein.
`
`33.
`
`CIGNA
`
`has
`
`been
`
`enriched
`
`by withholding
`
`payments
`
`due ALLIANCE
`
`for
`
`its performance
`
`for CIGNA's
`
`insured.
`
`of health
`
`care
`
`services
`
`34.
`
`In
`
`total,
`
`CIGNA
`
`failed
`
`to
`
`pay
`
`ALLIANCE
`
`in
`
`excess
`
`of
`
`$300,000
`
`to
`
`compensate
`
`ALLIANCE
`
`for
`
`the
`
`services
`
`provided
`
`to CIGNA's
`
`insured.
`
`35.
`
`Equity
`
`and
`
`good
`
`conscience
`
`demand
`
`that CIGNA
`
`compensate
`
`ALLIANCE
`
`in the
`
`amount
`
`of at
`
`least
`
`$300,000,
`
`the
`
`exact
`
`amount
`
`to be determined
`
`at
`
`trial.
`
`36.
`
`By
`
`reason
`
`of
`
`the
`
`foregoing,
`
`ALLIANCE
`
`is entitled
`
`to money
`
`judgment
`
`in the
`
`amount
`
`of
`
`at
`
`least
`
`the
`
`exact
`
`amount
`
`to be determined
`
`at
`
`interest
`
`from
`
`March
`
`2020
`
`$300,000,
`attorneys'
`
`fees.
`
`and
`
`trial,
`
`plus
`
`18,
`
`AS AND FOR A THIRD
`DECLARATORY
`
`OF ACTION
`CAUSE
`JUDGMENT
`
`FOR
`
`37.
`
`Plaintiff
`
`repeats,
`
`reiterates
`
`and
`
`realleges
`
`each
`
`and
`
`every
`
`allegation
`
`contained
`
`in
`
`paragraphs
`
`1 through
`
`36 with
`
`the
`
`same
`
`force
`
`and
`
`effect
`
`as if
`
`set
`
`forth
`
`at
`
`length
`
`herein.
`
`38.
`
`Plaintiff
`
`demands
`
`a judgment
`
`that
`
`this
`
`Court
`
`declares
`
`the
`
`legal
`
`rights,
`
`relations
`
`and
`
`duties
`
`of
`
`the
`
`parties
`
`with
`
`respect
`
`to the
`
`following
`
`matters:
`
`that
`
`the
`
`claims
`
`submitted
`
`for
`
`payment
`
`i)
`
`by ALLIANCE
`
`to CIGNA
`
`after March
`
`18,
`
`2020,
`
`shall
`
`not
`
`be rejected
`
`by CIGNA
`
`on the
`
`basis
`
`of a failure
`
`to provide
`
`insured's
`
`medical
`
`records,
`
`except
`
`ALLIANCE's
`
`laboratory
`
`reports;
`
`that
`
`the
`
`claims
`
`submitted
`
`for
`
`payment
`
`ii)
`
`by ALLIANCE
`
`to CIGNA
`
`between
`
`March
`
`18,
`
`2020
`
`and
`
`present
`
`be paid.
`
`WHEREFORE,
`ON THE FIRST
`
`1.
`
`amount
`
`of at
`
`18, 2020
`
`and
`
`it
`
`is respectfully
`
`requested
`
`that
`
`judgment
`
`be entered
`
`as follows:
`
`CAUSE
`
`OF ACTION,
`
`a money
`
`judgment
`
`in favor
`
`of Plaintiff
`
`in the
`
`the
`
`exact
`
`amount
`
`to be determined
`
`at
`
`trial,
`
`plus
`
`interest
`
`from
`
`March
`
`least
`
`$300,000,
`attorneys'
`
`fees;
`
`-4-
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`4 of 5
`
`
`
`INDEX NO. 508684/2021
`FILED: KINGS COUNTY CLERK 04/13/2021 04:07 PM
`Case 1:21-cv-02671 Document 1-1 Filed 05/12/21 Page 6 of 6 PageID #: 11
`NYSCEF DOC. NO. 2
`RECEIVED NYSCEF: 04/13/2021
`
`2.
`
`ON THE SECOND
`
`CAUSE
`
`OF ACTION,
`
`a money
`
`judgment
`
`in
`
`favor
`
`of Plaintiff
`
`in
`
`the
`
`amount
`
`of
`
`at
`
`least
`
`March
`
`18, 2020
`
`and
`
`$300,000,
`attorneys'
`
`the
`
`exact
`
`amount
`
`to
`
`be
`
`determined
`
`at
`
`trial,
`
`plus
`
`interest
`
`from
`
`fees;
`
`3.
`
`ON THE
`
`THIRD
`
`CAUSE
`
`OF
`
`ACTION,
`
`a
`
`declaratory
`
`judgment
`
`that
`
`this
`
`Court
`
`declares
`
`the
`
`legal
`
`rights,
`
`relations
`
`and
`
`duties
`
`of
`
`the
`
`parties
`
`with
`
`respect
`
`to the
`
`following
`
`matters:
`
`submitted
`
`payment
`
`to CIGNA
`
`after March
`
`that
`
`the
`
`claims
`
`i)
`
`for
`
`by ALLIANCE
`
`18,
`
`2020,
`
`shall
`
`not
`
`be rejected
`
`by CIGNA
`
`on the
`
`basis
`
`of a failure
`
`to provide
`
`insured's
`
`medical
`
`records,
`
`except
`
`ALLIANCE's
`
`laboratory
`
`reports;
`
`that
`
`the
`
`claims
`
`submitted
`
`for
`
`payment
`
`ii)
`
`by ALLIANCE
`
`to CIGNA
`
`between
`
`March
`
`18,
`
`2020
`
`and
`
`present
`
`be paid
`
`and
`
`4.
`
`Granting
`
`Plaintiff
`
`other
`
`relief
`
`that
`
`this Court
`
`may
`
`deem just
`
`and
`
`proper.
`
`Dated:
`
`New York
`New York,
`April
`13, 2021
`
`P.C.
`
`Popik,
`
`The
`
`of Roman
`Law
`Office
`for Plaintiff
`Attomeys
`40th FlOOr
`17 State
`Street,
`New York,
`New York
`10004
`562-
`(646)
`
`By:
`
`Roman
`
`Popik,
`
`Es
`
`-5 -
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`5 of 5
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`