By Matthew Hendley
By Monica Alonzo
By Monica Alonzo
By Monica Alonzo
By Stephen Lemons
By Jason P. Woodbury
By Dulce Paloma Baltazar Pedraza
By Ray Stern
CIGNA sent only the Ewerses' application for their 1985 policy. No contracts were sent.
So Karen Ewers turned to the Arizona Department of Insurance for more information. Ewers met with Steven Gelbart, an analyst for the department.
Gelbart later called Ewers to set up a meeting. Gelbart told Ewers he couldn't "find anything specific," Ewers says, but that he suspected the Ewers family had been put in "an insurance premium death spiral."
Soon after, the Ewerses, still struggling financially, decided they could no longer keep up with the CIGNA payments. They stopped their CIGNA policy and turned to state-supported Arizona Longterm Care to cover Ryan.
Busy with the jewelry store, building spec homes with her husband and caring for Ryan, Karen dropped her pursuit of the documents.
But as life went on, those strange dealings with CIGNA lingered in the back of her mind. Death spiral or not, why had she been called into the company president's office and grilled about what records she had? Why hadn't CIGNA just turned over her records so she could review them? After all, CIGNA was legally obligated to turn over much of what her attorney asked for. Something seemed amiss.
So, in the spring of 1999, after the spec homes were finished and life had settled a bit, Ewers decided to return to the Department of Insurance to find an answer to her insurance mystery.
On April 28, 1999, Ewers went to the Life and Health section of the Department of Insurance asking to review all CIGNA insurance documents from 1983 to 1996.
Ewers says a secretary named Betty Sickinger helped her. To make the request manageable, Ewers says she told Sickinger that she would like to review the most recent five years of HMO documents filed with the state. And when she was finished with those, she would like to review the next five years back, and so on, until she had seen them all. Ewers filled out a public-records request form and set an appointment for May 12.
On May 12, Ewers and a friend, Maria Palmer, former chief financial officer of Westbridge Children's Mental Health Hospital, went to the department to review CIGNA records. Sickinger brought out two metal carts with 12 large boxes and told Ewers and Palmer to place Post-it notes on any documents they wanted copied.
Ewers and Palmer had several documents copied. The most important page, they felt, was a December 31, 1997, letter from CIGNA requesting a minor language change to all of CIGNA's contracts. The letter then listed all applicable contracts, including one conversion contract, Individual Service Agreement Conversion 92-001, or ISAC 92-001, which was filed in December of 1991.
Sickinger called Ewers on May 14 to tell her the copies were ready. Ewers went to the department around 4 p.m. Sickinger had left for the day, so Ewers was assisted by another secretary, Mary Sosa.
Karen Ewers and Department of Insurance officials describe the ensuing conversation differently.
Ewers says she paid for the copies and then said she wanted to set up an appointment to review contract ISAC 92-001. Ewers says the secretary told her she would have to get permission from a supervisor to set up the appointment. The secretary returned with permission and they set up an appointment for 10 a.m. May 26 to review that particular document. Ewers wrote the time and date at the top of one of her copies.
(The secretary Ewers spoke to denies that she set up an appointment to review the contract.)
Four days after Ewers says she set up the appointment to review the contract, she received a call from Betty Sickinger. Sickinger told Ewers the document she wanted to see was unavailable because all HMO documents prior to December 31, 1992, had been purged.
Sickinger didn't say when the documents had been destroyed.
On May 20, Ewers visited the Department of Insurance again to review the department's "control logs," the department's registry of all documents submitted to it by insurance companies.
In the control logs, she found an entry describing the approval of the benefits schedule she had mailed to CIGNA with her complaint letter in 1995.
The ledger cards identified the form as the plan brochure for the Individual Medically Underwritten Plan that CIGNA said Ewers had never applied for.
There was another problem. Two sets of ledger cards were missing -- the cards for March through August of 1987 and for February 1988 until June of 1989, months that Ewers believed contained entries critical to her case. Steven Gelbart said he would try to find the missing ledger cards.
Two weeks later, in early June, Ewers called the Arizona Department of Library, Archives and Public Records requesting a copy of the document disposal report from the Department of Insurance's division of life and disability. It's standard procedure for departments to send files to the archives department for filing or destruction.
The next day, she received a list from archives that did not include the HMO records she had requested.
Ewers called Sickinger. Sickinger sent Ewers a fax listing cartons of CIGNA records that had been sent to state records and archives.
Ewers and an employee of records and archives reviewed the fax from Sickinger. The employee said that because of the volume of CIGNA's records, it was improbable that all of them were included in those cartons.