Rudy Lai

AI @ Cigna

Insurance and pharmacy benefits manager
Industry
Last updated
July 3, 2025 at 10:44 AM

Summary

  • Since 2019, Cigna has progressively integrated AI across healthcare and insurance operations, shifting from early applications in patient medication adherence and chronic disease management to advanced generative AI tools by 2025, including an AI-powered virtual assistant engaging over two-thirds of users proactively with 80% finding it helpful.
  • Despite advances and AI-driven digital tool rollouts improving customer experience and operational efficiency, Cigna has faced legal challenges in 2023 and early 2025 alleging inappropriate use of AI algorithms in claims denial, raising concerns about AI governance and ethics in healthcare insurance.
  • Cigna's recent AI strategy emphasizes ethical AI governance via an AI Center of Enablement, extensive user-centric tool development within the myCigna portal, and plans for expanded personalized services, focusing on improving customer experience, reducing administrative burdens, and enhancing health outcomes, though explicit ROI figures remain undisclosed.

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5 AI Use Cases at Cigna

Customer Service
2025
Customer Facing
Traditional
Generative
Agentic
Outcome
Cigna launched an AI-powered generative virtual assistant that provides personalized, conversational responses to member inquiries on benefits, claims, and care, improving access, engagement, and satisfaction. [1][2]
Behavioral Health Support
2024
Traditional
Generative
Agentic
Outcome
Cigna leverages AI in applied behavior analysis (ABA) to assist providers by reducing administrative burden and enhancing precision in care delivery. [1]
Claims Processing
2023
Traditional
Generative
Agentic
Outcome
Costs
Cigna applies AI algorithms to automate and expedite claims assessment and denials, aiming to improve efficiency and HIPAA compliance, though this has attracted legal scrutiny over fairness. [1][2]
Recruitment Optimization
2023
Traditional
Generative
Agentic
Outcome
Costs
Cigna uses AI to revamp its internal recruitment system, improving visibility of career opportunities to employees and boosting internal hiring effectiveness. [1]
Medication Adherence
2019
Traditional
Generative
Agentic
Outcome
Cigna uses AI systems to monitor patient medication adherence and identify treatment gaps, particularly in chronic diseases, enabling improved care management and health outcomes. [1]

Timeline

2025 Q4: no updates

2025 Q3

1 updates

Analysis highlights Cigna's strategic integration of data, platforms, and predictive AI tools to consolidate dominance in insurance healthcare, though trust issues related to AI use remain a vulnerability.

2025 Q2

3 updates

Cigna unveiled advanced generative AI-powered digital tools within its myCigna portal, including a widely adopted AI virtual assistant offering personalized, conversational answers about health benefits, claims, and care. Early user adoption metrics display 67% proactive use and over 80% perceived helpfulness. Additional tools like personalized provider matching, real-time cost tracking, and smart claims submission were introduced, focusing on operational efficiency and enhancing customer experience.

2025 Q1

1 updates

Legal scrutiny continues with class action lawsuits accusing Cigna of wrongful claim rejections using AI algorithms.

2024 Q4: no updates

2024 Q3

2 updates

Cigna deployed AI to reduce administrative burdens in behavioral healthcare, optimize medication adherence and management, and reinforced ethical AI practices with the AI Center of Enablement controlling systemic safeguards.

2024 Q2: no updates

2024 Q1

1 updates

Cigna further detailed multiple AI use cases enhancing customer service, predictive risk management, and personalized healthcare solutions without disclosing detailed financial impacts.

2023 Q4

2 updates

Legal allegations continued with lawsuits accusing Cigna of using AI algorithms to wrongly reject insurance claims, while simultaneously advancing AI-driven claims processing systems focusing on efficiency and HIPAA compliance.

2023 Q3

3 updates

Cigna expanded AI into internal recruitment systems improving hiring visibility, and advanced AI governance via their AI Center of Enablement. However, the company faced multiple lawsuits alleging inappropriate AI use to deny insurance claims at scale, sparking debate on ethics and fairness in AI applications.

2023 Q2: no updates

2023 Q1: no updates

2022 Q4: no updates

2022 Q3: no updates

2022 Q2: no updates

2022 Q1: no updates

2021 Q4: no updates

2021 Q3

1 updates

Cigna highlighted the use of data analytics and AI to help improve patient outcomes, focusing on changing healthcare results beyond diagnosis.

2021 Q2: no updates

2021 Q1: no updates

2020 Q4: no updates

2020 Q3: no updates

2020 Q2: no updates

2020 Q1: no updates

2019 Q4

1 updates

AI systems were expanded to monitor patient medication adherence, helping identify treatment gaps in chronic diseases.

2019 Q3

1 updates

Cigna began leveraging AI technology to address critical healthcare challenges, particularly focusing on patient medication adherence and chronic disease treatment gaps.